Expert consensus on processes and operations of navigation-guided needle biopsy techniques for skull base tumors / 中华口腔医学杂志

Skull base surgery is an interdisciplinary subject. The anatomical structures in the skull base related to oral and maxillofacial surgery include parapharyngeal space, pterygopalatine fossa and infratemporal space. This operative area is one of the most challenging surgical areas in oral and maxillofacial surgery due to its deep site, complex anatomy and high risk. For skull base lesions, whether for preoperative biopsy or surgical treatment, there is a greater degree of difficulty and risk. Obtaining pathological information of the tumor preoperatively may help the surgeons optimize their treatment plan. Needle biopsy is one of the major minimally invasive ways to obtain the preoperative pathological results. The navigation technology, which is developing rapidly nowadays, provides a reliable assistance for deep tissue biopsy surgery. Experts from the Oral and Maxillofacial Surgery, Chinese Stomatological Association formulated an expert consensus on processes and operation of navigation-guided needle biopsy techniques for skull base tumors, so as to standardize and promote the application and operation of navigation-guided needle biopsy for skull base tumors.

Expert consensus on techniques of navigation-guided reconstruction of jaw defect / 中华口腔医学杂志

Deformities of the maxillofacial region following trauma and ablative surgery are devastating and not uncommon. Reconstruction of such defects is a surgically challenging procedure. Conventionally, reconstruction of the jaw defects lacks pre-operative customized planning and relies heavily on surgeons' experiences to ensure optimum surgical outcomes. The restoration of jaw shape and function has taken precedence after an extensive tumor resection surgery, especially in the current age of technological advancement. Thus, personalized and accurate reconstruction of jaw defects has become a new goal. Computer-assisted surgery especially navigation-assisted surgery has gained popularity of late, in reconstructing deformities and restoring facial symmetry, appearance and function in the maxillofacial region. This technology provides a clearer three-dimensional visualization of the area of interest and its relationship with the adjacent vital structures. With pre-operative virtual surgical planning, it allows more specific and accurate osteotomies, thus reducing the ischemia and total operating times substantially. The risk of complications is also minimized whilst improving the final surgical outcomes. The use of intra-operative navigation system and other computer-assisted surgical techniques in the surgery can significantly improve the precision of the reconstruction of jaw deformities and achieve personalized and functional reconstructive goals while enhancing the patients' quality of life post-operatively. The Society of Oral and Maxillofacial Surgery, Chinese Stomatological Association provides this professional perspective and present treatment protocol for navigation-guided reconstruction of jaw defect to allow standardization of the techniques while promoting its application among the oral and maxillofacial surgeons.

Expert consensus on navigation-guided unilateral delayed zygomatic fractures reconstruction techniques / 中华口腔医学杂志

The zygoma is located in the medial and lateral parts of the face, supporting the midfacial contour. The forward projection of the zygoma and the zygomatic arch expose them to frequent injury. Fractures of the zygoma can lead to displacement of the zygoma and the zygomatic arch, causing facial collapse deformity. For delayed zygomatic fractures, the loss of normal anatomical landmarks, caused by the malunion of the fracture lines and remodeling of the bony contour, makes it difficult to determine the correct positions of the zygomatic bones. In such cases, using traditional surgical methods, ideal and steady outcomes with satisfactory midface symmetry have been difficult to obtain. Nowadays, the application of digital surgical software and surgical navigation help surgeons to perform accurate preoperative simulations to obtain ideal 3-dimensional (3D) virtual surgical plans, and achieve accurate reduction by intraoperative navigation systems, which increase the accuracy and predictability of fracture reduction outcomes. Experts from the Oral and Maxillofacial Surgery Committee of the Chinese Stomatological Association have fully discussed and formulated an expert consensus on navigation-guided unilateral delayed zygomatic fracture reconstruction techniques, to standardize the clinical operation procedures and promote the application.

Expert consensus on navigation-guided unilateral orbital fractures and orbital floor reconstruction techniques / 中华口腔医学杂志

Orbital fractures and orbital floor reconstruction surgery is characterized by limited surgical exposure and high risks. Before the advent of digital technology, the design and implementation of the surgical scheme of orbital floor reconstruction surgery mainly depended on the intuitive understanding of imaging and the clinical experience of the surgeons, with strong unpredictability and experience dependence.Surgical navigation systems with real-time positioning and imaging functions, when used in orbital reconstruction surgery, can detect the real-time intraoperative position, avoid risks, and assist locating the reconstruction position to ensure the accuracy of orbital reconstruction, with the help of a preoperative surgical plan. Many studies have confirmed its effect. Unilateral orbital fractures and orbital floor reconstruction surgery is one of the earliest and most widely used surgical techniques in maxillofacial surgery. Experts from the Oral and Maxillofacial Surgery Committee of the Chinese Stomatological Association have fully discussed and formulated this expert consensus on navigation-guided unilateral orbital fractures and orbital floor reconstruction techniques, to standardize the clinical surgical procedures and promote its application.