Intraoperative Real-Time Image-Guided Fibular Harvest and Mandibular Reconstruction: A Feasibility Study on Cadaveric Specimens.

Autor: Grzybowski G; Department of Mechanical Engineering, Faculty of Applied Science, University of British Columbia, Vancouver, British Columbia, Canada., Stewart MM; Department of Mechanical Engineering, Faculty of Applied Science, University of British Columbia, Vancouver, British Columbia, Canada., Milner TD; Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Dinur AB; Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., McGee OM; Department of Mechanical Engineering, Faculty of Applied Science, University of British Columbia, Vancouver, British Columbia, Canada., Pakdel A; Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Tran KL; Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Fels SS; Department of Electrical and Computer Engineering, Faculty of Applied Science, University of British Columbia, Vancouver, British Columbia, Canada., Hodgson AJ; Department of Mechanical Engineering, Faculty of Applied Science, University of British Columbia, Vancouver, British Columbia, Canada., Prisman E; Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2024 Oct 04. Date of Electronic Publication: 2024 Oct 04.
DOI: 10.1002/hed.27954
Abstrakt: Background: This study assesses the feasibility of real-time surgical navigation to plan and guide sequential steps during mandible reconstruction on a series of cadaveric specimens.
Methods: An image-guided surgical (IGS) system was designed including customized mandible and fibula fixation devices with navigation reference frames and an accompanied image-guided software. The mandibular and fibular segmental osteotomies were performed using the IGS in all five cadaveric patients. Procedural time and cephalometric measurements were recorded.
Results: Five real-time IGS mandibulectomy and fibular reconstruction were successfully performed. The mean Dice score and Hausdorff-95 distance between the planned and actual mandible reconstructions was 0.8 ± 0.08 and 7.29 ± 4.81 mm, respectively. Intercoronoid width, interangle width, and mandible projection differences were 1.15 ± 1.17 mm, 0.9 ± 0.56 mm, and 1.47 ± 1.62 mm, respectively.
Conclusion: This study presents the first demonstration of a comprehensive image-guided workflow for mandibulectomy and fibular flap reconstruction on cadaveric specimens and resulted in adequate cephalometric accuracy.
(© 2024 The Author(s). Head & Neck published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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