Assessment of the Learning Curve for Virtual Surgical Planning in Orbital Fractures

Abstract

Virtual surgical planning (VSP) is becoming more widely used in maxillofacial reconstruction and can be surgeon-based or industry-based. Surgeon-based models require software training but allow surgeon autonomy. We evaluate the learning curve for VSP through a prospective cohort study in which planning times and accuracy of 7 otolaryngology residents with no prior VSP experience were compared to that of a proficient user after a single training protocol and 6 planning sessions for orbital fractures. The average planning time for the first session was 21 minutes 41 seconds ± 6 minutes 11 seconds with an average maximum deviation of 2.5 ± 0.8 mm in the lateral orbit and 2.3 ± 0.6 mm in the superior orbit. The average planning time for the last session was 13 minutes 5 seconds ± 10 minutes and 7 seconds with an average maximum deviation of 1.4 ± 0.5 mm in the lateral orbit and 1.3 ± 0.4 mm in the superior orbit. Novice users reduced planning time by 40% and decreased maximum deviation of plans by 44% and 43% in the lateral and superior orbits, respectively, approaching that of the proficient user. Virtual surgical planning has a quick learning curve and may be incorporated into surgical training.

Customized Titanium Reconstruction of Orbital Fractures Using a Mirroring Technique for Virtual Reconstruction and 3D Model Printing

“…Dividing the raters into consultants and residents, we found substantial to almost perfect interrater reliability for the consultants, but poor to fair reliability for the residents. Thus, even though intraoperative 3D imaging and the aid of virtual reconstruction is useful, a thorough understanding of the surgical procedure is required, and surgical experience is requisite for obtaining superior results in orbital surgery, as confirmed in another study [34].…”

Advantages of a Training Course for Surgical Planning in Virtual Reality for Oral and Maxillofacial Surgery: Crossover Study

“…For this reason, the process of learning how to operate such CAS-related software has already been the subject of research in the literature. For example, learning curves upon repetition have been found for VSP for the treatment of orbital fractures or in orthognathic surgery [ 15 , 47 ]. In addition, differences in learning curves when it comes to CAD programs used in dentistry have been found between different software and professional groups (students, technicians, and dentists) [ 18 , 33 ].…”

“…The measurable stronger learning effect in the VR environment was also perceived by the participants ( Table 2 ). This is important, as the faster learning of CAD software, such as that for VSP, is also accompanied by increased planning and surgical accuracy, and improved anatomical understanding of the target structures [ 15 , 47 ]. Independent of segmentation performance, it is assumed that for different DS software, with correspondingly longer training periods, the differences will eventually cease to exist [ 33 ].…”

Primary Orbital Reconstruction with Selective Laser Melting (SLM) of Patient-Specific Implants (PSIs): An Overview of 96 Surgically Treated Patients

“…Thereby, our study is limited due to one single planning and operating surgeon, which makes the transfer of the results especially difficult in situations using less experienced, younger surgeons. Moreover, it has been shown that the learning curve of virtual planning for orbital fractures is steep [ 27 ], and intraoperative navigation offers more security for experienced as well as inexperienced surgeons [ 28 ].…”