Real-time image-guided recontouring in the management of craniofacial fibrous dysplasia

Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Dec;116(6):680-5. doi: 10.1016/j.oooo.2013.07.012. Epub 2013 Oct 8.

Abstract

Objective: This report presents our experience using computer-aided recontouring in the surgical management of complex craniofacial fibrous dysplasia with the use of a navigation system developed by the authors.

Study design: A total of 21 patients (9 men and 12 women) with craniofacial fibrous dysplasia and mean age of 23 years (range, 17-32 years) were included in this study from 2007 to 2012. By creating a mirror image of the unaffected side on the affected side as a virtual treatment template, we completed the recontouring procedures in real time with the aid of the navigation system that we developed (Accu-Navi). The surgical outcome was assessed by superimposing the postoperative computed tomography (CT) images onto the preoperative CT images.

Results: The precise preoperative simulation and intraoperative navigation enabled the surgeon to complete the recontouring procedure visually. Postoperative CT was compared with the preoperative plan, yielding an average discrepancy of <1.0 mm. Postoperative follow-up found that both facial aesthetics and patient satisfaction improved remarkably.

Conclusions: Navigation-guided recontouring shows benefits in improving accuracy and safety for this complicated procedure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Craniofacial Abnormalities / diagnostic imaging
  • Craniofacial Abnormalities / surgery*
  • Facial Asymmetry / diagnostic imaging
  • Facial Asymmetry / surgery
  • Facial Bones / diagnostic imaging
  • Facial Bones / surgery
  • Female
  • Fibrous Dysplasia of Bone / diagnostic imaging
  • Fibrous Dysplasia of Bone / surgery*
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Plastic Surgery Procedures / methods*
  • Surgery, Computer-Assisted / methods*
  • Tomography, X-Ray Computed
  • Treatment Outcome