Computer-Assisted Innovations in Craniofacial Surgery

Abstract

Reconstructive surgery for complex craniofacial defects challenges even the most experienced surgeons. Preoperative reconstructive planning requires consideration of both functional and aesthetic properties of the mandible, orbit, and midface. Technological innovations allow for computer-assisted preoperative planning, computer-aided manufacturing of patient-specific implants (PSIs), and computer-assisted intraoperative navigation. Although many case reports discuss computer-assisted preoperative planning and creation of custom implants, a general overview of computer-assisted innovations is not readily available. This article reviews innovations in computer-assisted reconstructive surgery including anatomic considerations when using PSIs, technologies available for preoperative planning, work flow and process of obtaining a PSI, and implant materials available for PSIs. A case example follows illustrating the use of this technology in the reconstruction of an orbital-frontal-temporal defect with a PSI. Computer-assisted reconstruction of complex craniofacial defects provides the reconstructive surgeon with innovative options for challenging reconstructive cases. As technology advances, applications of computer-assisted reconstruction will continue to expand.

Porous polyethylene implants in facial reconstruction: Outcome and complications

“…Compared to other studies of porous polyethylene outcomes, in which complication rates range from 10.3% to 26.3% (Baumann et al, 2002;Hollier et al, 2001;Rudman et al, 2011), the rate of complications reported in the present study is high (31.8%). A plausible explanation for this high rate of complications is the inclusion of patient dissatisfaction with the aesthetic result as a postoperative complication.…”

“…The computer-assisted reconstruction of maxillofacial defects could provide a more predictable aesthetic outcome for patients using porous polyethylene implants. Although many case reports discuss computer-assisted preoperative planning and creation of custom implants, a general overview of computer-assisted innovations and their treatment outcomes is not readily available (Rudman et al, 2011). Hence, further research is needed to determine whether these technological advances can improve the aesthetic results of porous polyethylene implants.…”

“…The planning of reconstructive surgeries for complex craniofacial defects challenges even the most experienced surgeons (Rudman et al, 2011). Craniofacial defects can be a result of trauma, malformations, or iatrogenic surgical defects.…”

Anatomical Reproducibility through 3D Printing in Cranio-Maxillo-Facial Defects

“…The virtual model is manufactured in a direct or indirect form (Ibrahim et al, 2009;Cantín et al, 2015). In surgery, medicine and odontology, the process on CAD begins with the computerized tomography of the patient (Rudman et al, 2011). The images used in this process require a compatibility with some shapes until the precision of the models are acceptable to the stereolithographic model (Ibrahim et al), although in the transfer and processing of information, for example in STL archives, there could exist a loss of data (Huotilainen et al, 2013).…”

Current role in facial allograft transplantation: what have we learned?

“…[4,5,[24][25][26] Preclinical planning studies for implementation and validation of tools for planning, design and adaptation of allograft into recipients are other key aspects for anatomical structures of donors and recipients are consistent in size and configuration to allow a reasonable accommodation. Anthropometric study of facial soft and hard tissues both the donor and the recipient must be as accurate as possible to ensure the viability of the procedure and the proper insertion of the allograft into the defect, [27][28][29] even including the preparation of preoperative surgical osteotomy guides. [30][31][32] …”