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Three-dimensional imaging in craniofacial surgery

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Abstract

Over the past decade, three-dimensional (3-D) imaging has been developed to such a stage of perfection and to such a level of interactive selective imaging of specific anatomic and pathologic structures that craniofacial surgeons can now use this technique effectively in the planning of complicated reconstructive surgery. In addition, modeling techniques have been devised that can be used in surgical simulation and in the manufacture of implants and prosthetic devices.

The technical aspects of 3-D imaging are discussed in relation to their applications in Craniofacial Surgery, and reference is made to the literature describing these techniques in full detail.

The results are illustrated with cases that the authors have processed by means of: (a) a clinical research program that was developed on a general purpose computer which provided full flexibility in changing and improving the reconstruction algorithms (Lobregt algorithms and DEC VAX 750 computer), (b) a system under development (Pixar PICS 2000), and (c) a commercial system (Cemax 1500X).

Finally, a number of emerging techniques are discussed such as surgical simulation (electronic sculpting), and trends such as multimodality imaging.

Résumé

Au cours de la dernière décennie, l'imagerie en trois dimensions (3 D) s'est grandement développée. Les images sont d'une telle perfection et maniabilité qu'avec une bonne sélection de structures anatomiques et pathologiques, les chirurgiens craniofaciaux peuvent utiliser cette technique dans la chirurgie reconstructrice compliquée. Des techniques de modelage ont été élaborées, permettant des simulations et aidant à fabriquer implants et prothèses.

Les aspects techniques des images en 3 D sont discutés quant à leurs applications en chirurgie craniofaciale. Ces techniques ont été bien décrites dans la littérature.

Les résultats sont illustrés avec des exemples traités par les auteurs grâce à: (a) un programme de recherche clinique développé sur un ordinateur à tout usage permettant la flexibilité dans les modifications et l'amélioration des algorithmes de reconstruction (Lobregt algorithms et ordinateur DEC VAX 750), (b) un système en voie de développement (Pixar PICS 2000), et (c) un système commercialisé (Cemax 1500X).

Enfin, les techniques nouvelles comme la simulation chirurgicale (sculpture électronique), et l'imagerie combinée sont discutées.

Resumen

En el curso del Último decenio las imágenes diagnósticas tridimensionales han alcanzado tal grado de desarrollo en cuanto a perfección y a la demostración selectiva de estructuras anatómicas y patológicas específicas que los cirujanos craneofaciales pueden ya utilizar efectivamente esta tecnología en la planeación de operaciones reconstructivas complejas. Además, se han diseñado técnicas de modelaje que pueden ser empleadas para la simulación quirÚrgica y para la manufactura de implantes y de elementos protésicos.

Los aspectos técnicos de las imágenes diagnósticas tridimensionales son discutidos en este artículo en relación a sus aplicaciones en la cirugía craneofacial haciendo referencia a la literatura que las describe en forma detallada.

Los resultados aparecen ilustrados con casos que los autores han procesado por medio de: (a) un programa de investigación clínica desarrollado en computador de uso general, el cual provee una total flexibilidad para modificar y mejorar los algorritmos de reconstrucción (algorritmos Lobregt y computador DEC VAX 750), (b) un sistema en fase de desarrollo (Pixar PICS 2000), y (c) un sistema comercial (Cemax 1500X).

Por Último, se discuten una serie de técnicas que comienzan a surgir, tales como la estimulación quirÚrgica (esculturación electrónica), y otras perspectivas tales como las imágenes por métodos multimodales.

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Authors and Affiliations

  1. Department of Radiology, Utrecht University Hospital, P.O. Box 16250, 3500, CG Utrecht, The Netherlands

    Frans W. Zonneveld Ph.D., Steven Lobregt M.Sc, Jacques C. H. van der Meulen M.D., Ph.D. & J. Michiel Vaandrager M.D.

  2. Philips Medical Systems Division, Best, The Netherlands

    Frans W. Zonneveld Ph.D., Steven Lobregt M.Sc, Jacques C. H. van der Meulen M.D., Ph.D. & J. Michiel Vaandrager M.D.

  3. Department of Plastic and Reconstructive Surgery, Erasmus University Hospital, Rotterdam, The Netherlands

    Frans W. Zonneveld Ph.D., Steven Lobregt M.Sc, Jacques C. H. van der Meulen M.D., Ph.D. & J. Michiel Vaandrager M.D.

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  1. Frans W. Zonneveld Ph.D.
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The authors acknowledge the support of Philips Medical Systems Division, Cemax Inc., and Pixar Inc.

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Zonneveld, F.W., Lobregt, S., van der Meulen, J.C.H. et al. Three-dimensional imaging in craniofacial surgery. World J. Surg. 13, 328–342 (1989). https://doi.org/10.1007/BF01660745

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