Virtual planning of complex head and neck reconstruction results in satisfactory match between real outcomes and virtual models

Hanken, Henning; Schablowsky, Clemens; Smeets, Ralf; Heiland, Max; Sehner, Susanne; Riecke, Björn; Nourwali, Ibrahim; Vorwig, Oliver; Gröbe, Alexander; Al‐Dam, Ahmed

doi:10.1007/s00784-014-1291-5

Cited by 44 publications

(41 citation statements)

References 28 publications

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“…There is accumulating evidence that this may be more efficient then traditional techniques, especially in complicated reconstructions . In mandibular reconstruction, using the fibula, VSP can be accurate to the millimeter with less than 10 degrees of difference in segment positioning . Applying VSP for scapular reconstruction may have additional benefits, particularly when a surgeon has less familiarity with the available bone stock.…”

Section: Discussionmentioning

confidence: 99%

“…23,24 In mandibular reconstruction, using the fibula, VSP can be accurate to the millimeter with less than 10 degrees of difference in segment positioning. 25 Applying VSP for scapular reconstruction may have additional benefits, particularly when a surgeon has less familiarity with the available bone stock. Preoperative planning allows for identification of the thickest portion of bone, which is particularly important for osteointegrated dental implant placement.…”

Section: Discussionmentioning

confidence: 99%

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Guide design in virtual planning for scapular tip free flap reconstruction

Kass

Prisman

Miles

2018

Laryngoscope Investig Oto

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BackgroundVirtual surgical planning (VSP), intraoperative cutting guides and stereolithographic models, provides the head and neck reconstructive surgeon with powerful tools for complex reconstruction planning. Despite its use in fibular osteocutaneous reconstruction, application to the scapular tip has not been as widely reported.MethodsFrom 2013 to 2014, four cases of either mandibular or maxillary reconstruction were completed with the scapular tip osseous free flap. All four cases underwent preoperative VSP with patient‐specific guide design.ResultsPatient‐specific guides were generated for scapular tip harvest. Guide placement was improved using a stabilizing flange and bracket design. With minimal disruption of the overlying periosteum a wedge osteotomy was successfully implemented in one case.ConclusionsUnlike the fibula and iliac crest donor sites, the scapular tip has overlying muscle attachments that make intraoperative osteotomies challenging. Attention to key aspects of scapular anatomy, including the fibrous tip and extensive overlying muscle, permits effective guide design.Level of evidence4

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Guide design in virtual planning for scapular tip free flap reconstruction

Kass

Prisman

Miles

2018

Laryngoscope Investig Oto

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“…Even though there are studies which compare segmented CBCT scans of the reconstructed jaw with the virtual plans (Hanken et al, 2014;Roser et al, 2010), these studies probably also experienced scattering as they report volume reductions of up to 30% of the post-operative fibula osteotomized parts. Also differences in the CBCT scanner or the scan protocol can account for the amount of scattering we experienced in our post-operative scans.…”

Section: Discussionmentioning

confidence: 99%

“…3D-printed cutting guides abutting on surrounding tissue such as bone, soft tissue or teeth are used intraoperatively to translate a 3D virtual surgical plan into reality. However, the accuracy with which these guides translate the surgical plan to the surgical outcome has rarely been assessed (Roser et al, 2010;Foley et al, 2013;Hanken et al, 2014). A precisely executed reconstruction of a mandibular or maxillary defect combined with implant insertion may reduce the risk of inappropriate positioning of the implants and could be more cost effective.…”

Section: A N U S C R I P Tmentioning

confidence: 99%

Accuracy of fibula reconstruction using patient-specific CAD/CAM reconstruction plates and dental implants: A new modality for functional reconstruction of mandibular defects

Schepers

Raghoebar

Vissink

et al. 2015

Journal of Cranio-Maxillofacial Surgery

129

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“…25-27 A comparison by Strong et al of 3 optical based navigation systems using a head frame for reference yielded an error of 1.00-1.34 mm. 22 Casap et al compared 2 navigation systems for mandibular positioning.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the OsteoMark-Navigation System for Oral and Maxillofacial Surgery

Magill

Tricomi

Murphy

et al. 2015

Journal of Oral and Maxillofacial Surgery

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Purpose To assess the accuracy of a novel navigation system for maxillofacial surgery using human cadavers and a live minipig model. Methods We describe and test an electromagnetic tracking system (OsteoMark Navigation) that uses simple sensors to determine position and orientation of a hand held pencil-like marking device. The device can translate 3-dimensional computed tomographic data intraoperatively to allow the surgeon to localize and draw a proposed osteotomy or the margins of a tumor on the bone. The accuracy of OsteoMark-Navigation in locating and marking osteotomies and screw positions in human cadaver heads was assessed. In Group 1 (n=3, 6 sides), Osteomark-Navigation marked osteotomies and screw positions were compared to virtual treatment plans In Group 2 (n=3, 6 sides), marked osteotomies and screw positions for distraction osteogenesis devices were compared to those carried out using fabricated guide-stents. Three metrics were used to document precision and accuracy. In Group 3 (n=1), the system was tested in a standard operating room environment. Results For Group 1, the mean error between points was 0.7mm (horizontal) and 1.7mm (vertical). When compared to the posterior and inferior mandibular border the mean error was 1.2 and 1.7mm, respectively. For Group 2, the mean discrepancy between points marked by Osteomark-Navigation and the surgical guides was 1.9 mm (range 0-4.1 mm). The system maintained accuracy on a live minipig in a standard operating room environment. Conclusion Based on this research OsteoMark-Navigation is potentially a powerful tool for clinical use in maxillofacial surgery. It has accuracy and precision comparable to existing clinical applications.

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Virtual planning of complex head and neck reconstruction results in satisfactory match between real outcomes and virtual models

Abstract: These highly satisfactory postoperative results are the basis for an optimal functional and aesthetic reconstruction in a single surgical procedure. The technique should be further investigated in larger study populations and should be further improved.

Cited by 44 publications

References 28 publications

Guide design in virtual planning for scapular tip free flap reconstruction

Guide design in virtual planning for scapular tip free flap reconstruction

Accuracy of fibula reconstruction using patient-specific CAD/CAM reconstruction plates and dental implants: A new modality for functional reconstruction of mandibular defects

Assessment of the OsteoMark-Navigation System for Oral and Maxillofacial Surgery

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