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

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-10-04 DOI:10.1002/hed.27954

Georgia Grzybowski, Molly Murray Stewart, Thomas D Milner, Anat Bahat Dinur, Orla M McGee, Amir Pakdel, Khanh Linh Tran, Sidney S Fels, Antony J Hodgson, Eitan Prisman

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Abstract

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.

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术中实时图像引导的腓骨摘除和下颌骨重建：尸体标本可行性研究

背景：本研究评估了在一系列尸体标本的下颌骨重建过程中使用实时手术导航来规划和指导顺序步骤的可行性：本研究评估了在一系列尸体标本上进行下颌骨重建时，通过实时手术导航来规划和指导连续步骤的可行性：方法：设计了一套图像引导手术（IGS）系统，包括带有导航参考框架的定制下颌骨和腓骨固定装置以及配套的图像引导软件。使用 IGS 对所有五例尸体患者进行了下颌骨和腓骨节段截骨术。结果：结果：成功实施了五例实时 IGS 下颌骨和腓骨重建术。计划与实际下颌骨重建之间的平均 Dice 评分和 Hausdorff-95 距离分别为 0.8 ± 0.08 和 7.29 ± 4.81 毫米。冠间宽、角间宽和下颌骨投影差异分别为 1.15 ± 1.17 毫米、0.9 ± 0.56 毫米和 1.47 ± 1.62 毫米：本研究首次在尸体标本上展示了下颌骨切除术和腓骨瓣重建的综合图像引导工作流程，并获得了足够的头颅测量精度。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.