Computer-Navigated Contouring of Craniofacial Fibrous Dysplasia Involving the Orbit

Abstract

Virtual surgical planning and computer-aided surgery were used to treat a mono-ostotic fibrous dysplasia of the right zygoma. Mirroring of the contralateral zygoma sets the target for the contouring of the affected zygomatic bone. An optical system for computer-guided surgery was used. Instruments were calibrated and visualized in real time on screen. Achievement of the virtually set target for the orbitozygomatic anatomy was assessed during surgery. Postoperative computed tomography and clinical follow-up confirmed an excellent result with regard to facial symmetry and eye bulb position. The volume of the orbit was increased from 24.2 to 26.0 mL compared with a contralateral orbital volume of 25.7 mL. Computer-guided surgery may be a useful tool in the surgical reduction of craniofacial fibrous dysplasia.

Our experience in the surgical management of craniofacial fibrous dysplasia: what has changed in the last 10 years?

“…The main one is the absence of instruments in some centres. Due to the low use in maxillofacial surgery, operative time is higher than with conventional techniques 23 .…”

Safe and rapid contouring of fibro-osseous lesions in the orbital area using navigation with minimally invasive cranial bone registration

“…3 We used this method for cases 1 and 2. 12,13 Navigation systems enable clear pre-operative surgical images and allow simulation of important steps, such as avoidance of the intracranial space, the nasal cavity and other critical structures. Imaging and drawing a preset goal without a reference is difficult and is associated with low accuracy.…”

“…Previous reports have described pre-operative simulation using navigation systems 12 , 13 . Navigation systems enable clear pre-operative surgical images and allow simulation of important steps, such as avoidance of the intracranial space, the nasal cavity and other critical structures.…”

Surgical Correction of Craniofacial Fibrous Dysplasia Involving Orbits: A Unique Application of Patient-Specific Implants

“…5 Atypical cases require histological confirmation for the final verdict. 6 When the disease affects the craniofacial skeleton, it might result in significant esthetic impairment with or without respective functional implications. The maxillary involvement might cause partial obstruction of airways, sinusitis, facial disfigurement, and expansion of the orbital floor.…”