Abstract
Surgery of fractures involving the skull base and the facial skeleton often presents challenges that should be addressed to prevent secondary brain injuries (i.e., cerebro-spinal fluid leak), preserve visual functioning, and guarantee a good esthetic result. Complex craniofacial reconstruction can be aided by navigation and pre-operative planning. In recent years, computerized planning of surgical reconstruction drastically increased the safety and efficacy of surgery, but the impact of intraoperative high quality image devices such as an intraoperative computed tomography (CT) scan has not been investigated yet. This case-control study reports the institutional preliminary experience of using intraoperative CT scans in the surgical management of complex cranio-facial fractures. The results in terms of accuracy of bony reconstruction and neurological or surgical complications have been analyzed in 12 consecutive patients treated with (6 cases) or without (6 cases) i-CT. Comparative analysis demonstrated a greater accuracy of reconstruction in patients treated with the assistance of i-CT. Intraoperative CT is a useful tool with a promising role in a multidisciplinary surgical approach to complex cranio-facial surgery.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Cuddy K, Khatib B, Bell RB, Cheng A, Patel A, Amundson M, et al. Use of intraoperative computed tomography in Craniomaxillofacial trauma surgery. J Oral Maxillofac Surg. 2018;76:1016–25. https://doi.org/10.1016/j.joms.2017.12.004.
Morrison CS, Taylor HO, Collins S, Oyelese A, Sullivan SR. Use of intraoperative computed tomography in complex craniofacial trauma: an example of on-table change in management. Craniomaxillofac Trauma Reconstr. 2014;7:298–301. https://doi.org/10.1055/s-0034-1378179.
Shyu VB, Chen H-H, Chen C-H, Chen C-T. Clinical outcome following intraoperative computed tomography-assisted secondary orbital reconstruction. J Plast Reconstr Aesthet Surg. 2021;74:341–9. https://doi.org/10.1016/j.bjps.2020.08.049.
Barbagallo GMV, Morrone A, Certo F. Intraoperative computed tomography and awake craniotomy: a useful and safe combination in brain surgery. World Neurosurg. 2018;119:e159–66. https://doi.org/10.1016/j.wneu.2018.07.078.
Barbagallo GMV, Palmucci S, Visocchi M, Paratore S, Attinà G, Sortino G, et al. Portable intraoperative computed tomography scan in image-guided surgery for brain high-grade gliomas: analysis of technical feasibility and impact on extent of tumor resection. Oper Neurosurg (Hagerstown). 2016;12:19–30. https://doi.org/10.1227/NEU.0000000000001112.
Barbagallo G, Maione M, Peschillo S, Signorelli F, Visocchi M, Sortino G, et al. Intraoperative computed tomography, navigated ultrasound, 5-amino-levulinic acid fluorescence and neuromonitoring in brain tumor surgery: overtreatment or useful tool combination? J Neurosurg Sci. 2019; https://doi.org/10.23736/S0390-5616.19.04735-0.
Barbagallo GMV, Altieri R, Garozzo M, Maione M, Di Gregorio S, Visocchi M, et al. High grade glioma treatment in elderly people: is it different than in younger patients? Analysis of surgical management guided by an intraoperative multimodal approach and its impact on clinical outcome. Front Oncol. 2020;10:631255. https://doi.org/10.3389/fonc.2020.631255.
Barbagallo GMV, Certo F, Di Gregorio S, Maione M, Garozzo M, Peschillo S, et al. Recurrent high-grade glioma surgery: a multimodal intraoperative protocol to safely increase extent of tumor resection and analysis of its impact on patient outcome. Neurosurg Focus. 2021;50:E20. https://doi.org/10.3171/2020.10.FOCUS20744.
Dai JH, Xu DD, Yang CY, Li ZB, Li Z. Treatment of sagittal fracture of the zygomatic arch root assisted by surgical navigation technology. J Craniofac Surg. 2018;29(4):1031–3. https://doi.org/10.1097/SCS.0000000000004276; PMID: 29381608.
Baek MK, Jung JH, Kim ST, Oh NR, Bang YJ, Kang IG. Is surgical navigation useful for treating zygomatic arch fractures? J Craniofac Surg. 2017;28(5):e417–9. https://doi.org/10.1097/SCS.0000000000003645; PMID: 28538075.
Catanzaro S, Copelli C, Manfuso A, Tewfik K, Pederneschi N, Cassano L, Cocchi R. Intraoperative navigation in complex head and neck resections: indications and limits. Int J Comput Assist Radiol Surg. 2017;12(5):881–7. https://doi.org/10.1007/s11548-016-1486-0; Epub 2016 Sep 22. PMID: 27659282.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Certo, F. et al. (2023). Image-Guided Surgery in Complex Skull Base and Facial Fractures: Initial Experience on the Role of Intra-Operative Computer Tomography. In: Visocchi, M. (eds) The Funnel: From the Skull Base to the Sacrum. Acta Neurochirurgica Supplement, vol 135. Springer, Cham. https://doi.org/10.1007/978-3-031-36084-8_11
Download citation
DOI: https://doi.org/10.1007/978-3-031-36084-8_11
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-36083-1
Online ISBN: 978-3-031-36084-8
eBook Packages: MedicineMedicine (R0)