Navigation-assisted maxillofacial reconstruction: accuracy and predictability |
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| Affiliation: | 1. Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, Beijing, People’s Republic of China;2. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;3. Department of Oral and Maxillofacial Surgery, Yinchuan Stomatology Hospital, Yinchuan, People’s Republic of China;1. Head and Neck Tumour Stream, Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia;2. School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia;3. Research Centre for Generational Health and Ageing, University of Newcastle, New Lambton Heights, NSW, Australia;4. Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia;5. Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia;6. Department of Surgical Oncology, Head and Neck Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia;7. Department of Medical Education, The University of Melbourne, Parkville, Victoria, Australia;1. Division of Family Dentistry, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan;2. Division of Oral Pathology, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan;3. Division of Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan;4. School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan;5. School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan;1. Craniofacial center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan;2. Department of Plastic and Reconstructive Surgery, Taipei Medical University Hospital, Taipei, Taiwan;1. Division of Oral and Maxillofacial Surgery, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil;2. School of Dentistry, Unichristus, Fortaleza, Ceará, Brazil;3. Department of Prosthesis and Oral and Maxillofacial Surgery, Dental School, Federal University of Pernambuco, Recife, Pernambuco, Brazil;4. Division of Oral Pathology, Unichristus, Fortaleza, Ceará, Brazil;5. Research Student Programme, “La Sapienza”, University of Rome, Rome, Italy;6. Department of Odontostomatological and Maxillofacial Sciences, “La Sapienza”, University of Rome, Rome, Italy;7. Department of Clinical and Preventive Dentistry, Dental School, Federal University of Pernambuco, Recife, Pernambuco, Brazil |
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| Abstract: | The aim of this study was to evaluate the accuracy of navigation-assisted maxillofacial reconstruction and to identify the predictors of the clinical outcomes. A total of 112 patients who underwent navigation-assisted maxillofacial reconstruction with free flaps between 2014 and 2019, performed by a single surgical team, were assessed. Accuracy was evaluated by superimposing the postoperative computed tomography data with the preoperative virtual surgical plan. Predictors of the clinical outcomes affecting the accuracy were identified and analysed. The mean deviation and root mean square (RMS) estimate of the orbital, maxillary, and mandibular reconstructions were 0.88 ± 3.25 mm and 3.38 ± 0.73 mm, 0.77 ± 3.44 mm and 3.69 ± 0.82 mm, and 1.07 ± 4.16 mm and 4.67 ± 3.95 mm, respectively (P < 0.05). There was no significant difference in orbital volume or projection between the preoperative, postoperative, and healthy orbits (P = 0.093 and P = 0.225, respectively). Multivariate linear regression analysis confirmed significant associations between the accuracy of navigation-assisted mandibular reconstruction and preservation of the condyle, type of reconstruction, type of osteosynthesis plate, and number of bony segments. Navigation-assisted midface reconstruction yielded a higher level of accuracy in the final surgical outcome when compared to mandibular reconstruction. Computer-assisted techniques and intraoperative navigation can be an alternative or adjunct to current surgical techniques to improve the final surgical outcome, especially in more complex maxillofacial reconstructions. |
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| Keywords: | oral cancer reconstructive surgery computer-assisted surgery surgical navigation head and neck neoplasm |
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