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Navigation-assisted maxillofacial reconstruction: accuracy and predictability.

H Y Soh1, L H Hu2, Y Yu2

  • 1Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, Beijing, People's Republic of China; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

International Journal of Oral and Maxillofacial Surgery
|December 4, 2021
PubMed
Summary
This summary is machine-generated.

Navigation-assisted maxillofacial reconstruction accurately restores facial structures, with midface procedures showing higher precision than mandibular ones. Key factors influencing accuracy include condyle preservation and reconstruction type.

Keywords:
computer-assisted surgeryhead and neck neoplasmoral cancerreconstructive surgerysurgical navigation

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Medical Engineering
  • Reconstructive Surgery

Background:

  • Maxillofacial reconstruction aims to restore form and function after trauma or oncologic resection.
  • Navigation-assisted surgery offers enhanced precision in complex anatomical reconstructions.
  • Evaluating the accuracy and predictors of outcomes in navigation-assisted maxillofacial reconstruction is crucial for optimizing patient care.

Purpose of the Study:

  • To assess the accuracy of navigation-assisted maxillofacial reconstruction using free flaps.
  • To identify clinical predictors influencing the accuracy of these reconstructions.
  • To compare the accuracy between midface and mandibular reconstructions.

Main Methods:

  • Retrospective analysis of 112 patients undergoing navigation-assisted maxillofacial reconstruction with free flaps.
  • Accuracy evaluation via superimposition of postoperative CT scans onto preoperative virtual surgical plans.
  • Multivariate linear regression to identify predictors of reconstruction accuracy.

Main Results:

  • Mean deviations for orbital, maxillary, and mandibular reconstructions were within millimeters, indicating high accuracy (P < 0.05).
  • No significant differences in orbital volume or projection were observed pre- and post-operatively.
  • Condyle preservation, reconstruction type, osteosynthesis plate, and bony segment number predicted mandibular reconstruction accuracy.
  • Navigation-assisted midface reconstruction demonstrated superior accuracy compared to mandibular reconstruction.

Conclusions:

  • Navigation-assisted techniques provide accurate outcomes in maxillofacial reconstruction, particularly for complex cases.
  • Midface reconstructions achieve higher accuracy than mandibular reconstructions.
  • Computer-assisted navigation is a valuable adjunct for improving surgical precision and outcomes in maxillofacial surgery.