Computer-aided surgical simulation and navigation in reconstruction of old maxillofacial fractures / 上海交通大学学报（医学版）

ABSTRACT

Objective To apply the three-dimensional pre-operative simulation and intra-operative real-time navigation in the reconstruction of old maxillofacial fractures so as to increase the surgical precision. Methods Six patients with old maxillofacial fractures were enrolled, and the diagnosis of unilateral old maxillofacial fractures was confirmed by clinical and imaging examinations. Virtual three-dimensional skull models were reconstructed from pre-operative CT images. The fractured bone was moved or rotated, and was reposed in a desired site according to the mirrored part from the healthy side. After patient-to-image registration, the surgical instruments and patients were tracked in real-time by optical tracking system during operation, and in this way the maxillofacial fractures were reposed satisfactorily guided by the virtual image. Results Three-dimensional simulation before operation and real-time navigation of patients and instruments during operation were realized. The error of registration was less than 1 mm. The post-operative CT examinations of these six patients revealed that the fracture reposition was same to the pre-operative planning, and the difference between them was less than 1.5 mm. The operations were minimally-invasive, with no complications. Conclusion Computer-aided surgical simulation and navigation system can effectively increase the surgical precision of reconstruction of old maxillofacial fractures.