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Surgical Navigation To Optimize Symmetry In The Treatment Of Craniofacial Fibrous Dysplasia
Garland CB, Bykowski MR, Hill AL, Goldstein JA
University of Pittsburgh, Department of Plastic Surgery
2016-02-15
Presenter: Amber Hill
Affidavit:
The proposal was primarily the work of the presenter.
Director Name: Joseph Losee
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Purpose: Due to the complex anatomy of the craniofacial skeleton, determining the resection amount to achieve facial symmetry can be difficult. The purpose of this report is to demonstrate how virtual surgical planning and surgical navigation technology may help to optimize facial symmetry.
Methods: We present a case report of a 12-year-old girl with fibrous dysplasia involving the right orbit, zygoma, maxilla, and skull base leading to diplopia and facial asymmetry. Preoperatively we performed virtual surgical simulation to plan her resection. Intraoperatively, surgical navigation technology was used to guide the resection. Preoperative and postoperative CT scans and both 2D and 3D patient photographs were compared to critically assess our results.
Results: Using 3D CT scan reconstructions for preoperative planning, we designed our surgical resection such that the right facial bones and orbit would match her normal left side. Models were created that provided a 3D representation of the amount of abnormal bone to be resected as well as the final anticipated result. Surgical navigation was used in real-time during the operation to allow for an accurate resection of the areas of fibrous dysplasia. Postoperative CT scan demonstrated excellent bony contour match of the resected side to the normal left side, and photographs demonstrated an improvement in facial symmetry.
Conclusions: Virtual surgical planning and surgical navigation technology are useful adjuncts in the treatment of craniofacial fibrous dysplasia. This technology provides the surgeon with real-time feedback during the operation and may help to optimize facial symmetry in the treatment of fibrous dysplasia.
