Indications and limitations of intraoperative navigation in maxillofacial surgery
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Indications and limitations of intraoperative navigation in maxillofacial surgery. / Heiland, Max; Habermann, Christian R; Schmelzle, Rainer.
In: J ORAL MAXIL SURG, Vol. 62, No. 9, 01.09.2004, p. 1059-63.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Indications and limitations of intraoperative navigation in maxillofacial surgery
AU - Heiland, Max
AU - Habermann, Christian R
AU - Schmelzle, Rainer
PY - 2004/9/1
Y1 - 2004/9/1
N2 - PURPOSE: Although primarily developed for neurosurgical application, intraoperative navigation has gained acceptance even in maxillofacial surgery with an increasing field of indications. We want to demonstrate our clinical experiences, focusing on the indications and limitations of intraoperative navigation.MATERIALS AND METHODS: In our department, the navigation system VectorVision (BrainLAB, Heimstetten, Germany) is used. The accuracy of this referencing method, consisting of a cortical fixed reference system and surface scanning, was checked by anatomic landmarks. Surgical treatment of 20 patients was performed with the help of the navigation system.RESULTS: The VectorVision system proved to be a useful supplement during the surgical exploration of complex anatomic regions. However, resolution of imaging data sets, errors of image fusion, and discrepancies during referencing increased the inaccuracy before surgery. The main problem was the topographic changes caused by surgery, resulting in discrepancies between the preoperative image data and the surgical site. In one case suffering from a meningioma extending to the neck, topography was changed by surgery making navigation inaccurate.CONCLUSION: Generally, a promising field for intraoperative navigation systems were small surgical approaches allowing only limited exposure. From our point of view, additional promising indications include vast tumors or recurrent tumors because of altered anatomy with lost landmarks during surgery. The same was the case of patients suffering from plexiform neurofibroma caused by neurofibromatosis type I. Further, intraoperative navigation was helpful to determine the position of foreign bodies during imaging, making the intraoperative location easier.
AB - PURPOSE: Although primarily developed for neurosurgical application, intraoperative navigation has gained acceptance even in maxillofacial surgery with an increasing field of indications. We want to demonstrate our clinical experiences, focusing on the indications and limitations of intraoperative navigation.MATERIALS AND METHODS: In our department, the navigation system VectorVision (BrainLAB, Heimstetten, Germany) is used. The accuracy of this referencing method, consisting of a cortical fixed reference system and surface scanning, was checked by anatomic landmarks. Surgical treatment of 20 patients was performed with the help of the navigation system.RESULTS: The VectorVision system proved to be a useful supplement during the surgical exploration of complex anatomic regions. However, resolution of imaging data sets, errors of image fusion, and discrepancies during referencing increased the inaccuracy before surgery. The main problem was the topographic changes caused by surgery, resulting in discrepancies between the preoperative image data and the surgical site. In one case suffering from a meningioma extending to the neck, topography was changed by surgery making navigation inaccurate.CONCLUSION: Generally, a promising field for intraoperative navigation systems were small surgical approaches allowing only limited exposure. From our point of view, additional promising indications include vast tumors or recurrent tumors because of altered anatomy with lost landmarks during surgery. The same was the case of patients suffering from plexiform neurofibroma caused by neurofibromatosis type I. Further, intraoperative navigation was helpful to determine the position of foreign bodies during imaging, making the intraoperative location easier.
KW - Adult
KW - Aged
KW - Child
KW - Craniofacial Abnormalities
KW - Equipment Design
KW - Facial Bones
KW - Female
KW - Foreign Bodies
KW - Head and Neck Neoplasms
KW - Humans
KW - Image Processing, Computer-Assisted
KW - Imaging, Three-Dimensional
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Neoplasm Recurrence, Local
KW - Oral Surgical Procedures
KW - Orbit
KW - Skull Fractures
KW - Stereotaxic Techniques
KW - Surgery, Computer-Assisted
KW - Tomography, X-Ray Computed
KW - User-Computer Interface
M3 - SCORING: Journal article
C2 - 15346354
VL - 62
SP - 1059
EP - 1063
JO - J ORAL MAXIL SURG
JF - J ORAL MAXIL SURG
SN - 0278-2391
IS - 9
ER -