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USE OF A COMPUTER NAVIGATION SYSTEM FOR OSTEOTOMIES IN THE ORTHOGNATHIC SURGERY: TECHNICAL NOTE  

Kim, Moon-Key (Department of Oral & Maxillofacial Surgery, National Health Insurance Corp. Ilsan Hospital)
Kang, Sang-Hoon (Department of Oral & Maxillofacial Surgery, National Health Insurance Corp. Ilsan Hospital)
Choi, Young-Su (Department of Oral & Maxillofacial Surgery, National Health Insurance Corp. Ilsan Hospital)
Kim, Jung-In (Department of Oral & Maxillofacial Surgery, National Health Insurance Corp. Ilsan Hospital)
Byun, In-Young (Department of Oral & Maxillofacial Surgery, National Health Insurance Corp. Ilsan Hospital)
Park, Won-Se (Department of General Dentistry, College of Dentistry, Yonsei University)
Lee, Sang-Hwy (Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University)
Publication Information
Maxillofacial Plastic and Reconstructive Surgery / v.32, no.3, 2010 , pp. 282-288 More about this Journal
Abstract
Surgery with the computer navigation system can make it possible to identify important anatomical structures which are difficult to be confirmed with the naked eye in the operation, and has extended their applications in various surgical fields. The head and neck surgery especially requires detailed anatomical knowledges and these knowledges have influences on postoperative functions and esthetics of a patient. In the orthognathic surgery, we should take osteotomies in the precise locations of the jawbones and move segments to the intended positions. There are so many important anatomical structures around the osteotomy-sites in the orthognathic surgery that the prevention of damage to these structures to obtain satisfactory results without any complication. There are vessels of the pterygoid plexus posterior to the pterygoid plate in the maxilla and the mandibular nerve enters the mandibluar foramen in the mandibular ramus. These locations should be confirmed perioperatively to avoid any injury to these structures. The navigation-assisted surgery may be helpful for this purpose. We performed navigational orthognathic surgeries with preoperative CT images and obtained satisfactory results. The osteotomy was performed in the proper location and damaging the surrounding important anatomical structures was avoided by keeping the saw away from them with the real-time navigation. It may be required to develop proper devices and protocols for the navigation-assisted orthognathic surgery.
Keywords
Computerized navigation surgery; Optical tracking system; Orthognathic surgery; Osteotomy;
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1 Willems PW, van der Sprenkel JW, Tulleken CA et al : Neuronavigation and surgery of intracerebral tumours. J Neurol 253 : 1123, 2006.   DOI   ScienceOn
2 Watanabe E, Watanabe T, Manaka S et al : Three-dimensional digitizer (neuronavigator) : new equipment for computed tomography-guided stereotaxic surgery. Surg Neurol 27 : 543, 1987.   DOI   ScienceOn
3 Hohlweg-Majert B, Schon R, Schmelzeisen R et al : Navigational maxillofacial surgery using virtual models. World J Surg 29 : 1530, 2005.   DOI   ScienceOn
4 Hassfeld S, Mu¨hling J : Navigation in Maxillofacial and Craniofacial Surgery. Comuter Aided Surg 3 : 183, 1998.   DOI   ScienceOn
5 Nijmeh AD, Goodger NM, Hawkes D et al : Image-guided navigation in oral and maxillofacial surgery. Br J Oral Maxillofac Surg 43 : 294, 2005.   DOI   ScienceOn
6 Widmann G, Stoffner R, Bale R : Errors and error management in image-guided craniomaxillofacial surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107 : 701, 2009.   DOI   ScienceOn
7 Panula K, Finne K, Oikarinen K : Incidence of complications and problems related to orthognathic surgery : A review of 655 patients. J Oral Maxillofac Surg 59 : 1128, 2001.   DOI   ScienceOn
8 Casap N, Wexler A, Perky N et al : Navigation surgery for dental implants : assessment of accuracy of the image guided implantology system. J Oral Maxillofac Surg 62 Suppl 2 : 116, 2004.
9 Casap N, Wexler A, Eliashar R : Computerized navigation for surgery of the lower jaw : comparison of 2 navigation system. J Oral Maxillofac Surg 66 : 1467, 2008.   DOI   ScienceOn
10 Marmulla R, Mu¨hling J, Lu¨th T et al : Advanced surfacerecording techniques for computer-assisted oral and maxillofacial surgery. Br J Oral Maxillofac Surg 42 : 511, 2004.   DOI
11 Kim SG, Park SS : Incidence of Complications and Problems Related to Orthognathic Surgery. J Oral Maxillofac Surg 65 : 2438, 2007.   DOI   ScienceOn
12 Schramm A, Gellrich NC, Gutwald R et al : Indications for computer-assisted treatment of cranio-maxillofacial tumors. Comput Aided Surg 5 : 343, 2000.   DOI   ScienceOn
13 Pham AM, Rafii AA, Metzger MC et al : Computer modeling and intraoperative navigation in maxillofacial surgery. Otolaryngol Head Neck Surg 137 : 624, 2007.   DOI
14 Schmelzeisen R, Gellrich NC, Schoen R et al : Navigationaided reconstruction of medial orbital wall and floor contour in cranio-maxillofacial reconstruction. Injury 35 : 955, 2004.   DOI   ScienceOn
15 Wittwer G, Adeyemo WL, Schicho K et al : Prospective randomized clinical comparison of 2 dental implant navigation systems. Int J Oral Maxillofac Implants 22 : 785, 2007.
16 Fujimura K, Segami N, Kobayashi S : Anatomical Study of the Complications of Intraoral-Vertico-Sagittal Ramus Osteotomy. J Oral Maxillofac Surg 64 : 384, 2006.   DOI   ScienceOn
17 Shramm A, Gellrich NC, Schmelzeisen R : Navigational Surgery of the Facial Skeleton. Berlin, Springer-Verlag, 2007.
18 Lanigan DT, Hey JH, West RA : Major vascular complications of orthognathic surgery : homorrage associated with Le Fort I osteotomies. J Oral Maxillofac Surg 48 : 561, 1990.   DOI
19 Casap N, Tarazi E, Wexler A et al : Intraoperative computerized navigation for flapless implant surgery and immediate loading in the edentulous mandible. Int J Oral Maxillofac Implants 20 : 92, 2005.
20 Siessegger M, Schneider BT, Mischkowski RA et al : Use of an image-guided navigation system in dental implant surgery in anatomically complex operation sites. J Craniomaxillofac Surg 29 : 276, 2001.   DOI   ScienceOn
21 Tsuji Y, Muto T, Kawakami J et al : Computed tomographic analysis of the position and course of the mandibular canal : relevance to the sagittal split ramus osteotomy. Int J Oral Maxillofac Surg 34 : 243, 2005.   DOI   ScienceOn
22 Feichtinger M, Schultes G, Karcher H : The use of a 3D navigation system in the treatment of mandibular angle fractures by minimally invasive insertion of Herbert screws for osteosynthesis. Comput Aided Surg 13 : 47, 2008.   DOI
23 Enchev Y : Neuronavigation: geneology, reality, and prospects. Neurosurg Focus 27 : 11, 2009.
24 Stone SS, Rutka JT : Utility of neuronavigation and neuromonitoring in epilepsy surgery. Neurosurg Focus 25 : 17, 2008.
25 Hassfeld S, Mu¨hling J : Computer assisted oral and max illofacial surgery - a review and an assessment of technology. Int J Oral Maxillofac Surg 30 : 2, 2001.   DOI   ScienceOn
26 Spiegel EA, Wycis HT, Marks M et al : Stereotaxic Apparatus for Operations on the Human Brain. Science 106 : 349, 1947.   DOI
27 Gildenberg PL : History repeats itself. Stereotact Funct Neurosurg 80 : 61, 2003.   DOI   ScienceOn
28 Ewers R, Schicho K, Undt G et al : Basic research and 12 years of clinical experience in computer-assisted navigation technology : a review. Int J Oral Maxillofac Surg 34 : 1, 2005.   DOI   ScienceOn