Interdisciplinary Surgical Management of Multiple Facial Fractures With Image-Guided Navigation

Abstract

Purpose: To evaluate the effectiveness of interdisciplinary surgical management of multiple facial fractures with image-guided surgical navigation. Patients and Methods: From 2011 through 2014, 36 patients with multiple facial fractures were enrolled in the study. With individual virtual 3-dimensional (3D) modeling, interdisciplinary planning and surgical simulation were carried out on an Accu-Navi software platform. Through an interactive collaboration among specialists, all patients underwent 1-stage open reduction under guidance of the navigation system. The outcome was assessed by superimposing the postoperative 3D computed tomographic (CT) model on the preoperative plan and clinical examination. Results: Through the registration procedure, an accurate match between the actual intraoperative position and the CT images was achieved within a systematic error of 1 mm. The fractured bone segments were released and repositioned according to the preoperative plan and simulation with the aid of instrument-and probe-based navigation. All patients underwent uneventful healing without serious complications. Postoperative assessment of surgical intervention showed a quantitative discrepancy less than 2 mm (1.49 +/- 0.27), showing a satisfactory concordance. Conclusion: In the interdisciplinary surgical management of multiple facial fractures, image-guided surgical navigation, including preoperative planning, surgical simulation, postoperative assessment, and computer-assisted navigation, proved an optimal strategy and valuable option for this potentially complicated procedure. (C) 2015 Published by Elsevier Inc on behalf of the American Association of Oral and Maxillofacial Surgeons