Abstract
Introduction
Intraoperative mobile Cone-Beam Computed Tomography (CBCT) trends to develop for the management of complex facial fractures. It allows a real-time imaging and surgical navigation.
Aim
Through the presentation of two clinical cases, we aimed at presenting the procedure of intra-operative CBCT and new applications in maxillofacial surgery.
Results
A young patient with extended orbito-frontal fibrous dysplasia, and a child with the recurrence of a temporomandibular joint ankylosis secondary to mastoïditis, were operated using a intra-operative imaging control. In both cases, the intraoperative CBCT increased precision and safety of the bone resection. No surgical complication was noted and a good healing was obtained.
Conclusion
Intraoperative CBCT raises the problems of radiation exposure and increased operating time. However, it represents a useful imaging tool and a navigation system in complex situations as osseous dysplasia and surgery of the temporo-mandibular joint.
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References
Holly LT, Foley KT (2007) Image guidance in spine surgery. Orthop Clin North Am 38(3):451–461 abstract viii
Carlson AP, Phelps J, Yonas H (2012) Alterations in surgical plan based on intraoperative portable head computed tomography imaging. J Neuroimaging 22(4):324–328
Yu H, Shen SG, Wang X, Zhang L, Zhang S (2013) The indication and application of computer-assisted navigation in oral and maxillofacial surgery-Shanghai’s experience based on 104 cases. J Cranio-Maxillofac Surg 41(8):770–774
Wilde F, Lorenz K, Ebner A-K, Krauss O, Mascha F, Schramm A (2013) Intraoperative imaging with a 3D C-arm system after zygomatico-orbital complex fracture reduction. J Oral Maxillofac Surg 71(5):894–910
van Hout WMMT, Van Cann EM, Muradin MSM, Frank MH, Koole R (2014) Intraoperative imaging for the repair of zygomaticomaxillary complex fractures: a comprehensive review of the literature. J Cranio-Maxillofac Surg 42(8):1918–1923
Morrison CS, Taylor HO, Collins S, Oyelese A, Sullivan SR (2014) Use of intraoperative computed tomography in complex craniofacial trauma: an example of on-table change in management. Craniomaxillofacial Trauma Reconstr 7(4):298–301
van Hout WMMT, Van Cann EM, Koole R, Rosenberg AJWP (2016) Surgical treatment of unilateral zygomaticomaxillary complex fractures: a 7-year observational study assessing treatment outcome in 153 cases. J Cranio-Maxillofac Surg 44(11):1859–1865
Pohlenz P, Blake F, Blessmann M, Smeets R, Habermann C, Begemann P, Schmelzle R, Heiland M (2009) Intraoperative cone-beam computed tomography in oral and maxillofacial surgery using a C-arm prototype: first clinical experiences after treatment of zygomaticomaxillary complex fractures. J Oral Maxillofac Surg Off 67(3):515–521
Heiland M, Schmelzle R, Hebecker A, Schulze D (2004) Intraoperative 3D imaging of the facial skeleton using the SIREMOBIL Iso-C3D. Dento Maxillo Facial Radiol 33(2):130–132
Bell RB (2010) Computer planning and intraoperative navigation in cranio-maxillofacial surgery. Oral Maxillofac Surg Clin N Am 22(1):135–156
van den Bergh B, Goey Y, Forouzanfar T (2011) Postoperative radiographs after maxillofacial trauma: sense or nonsense? Int J Oral Maxillofac Surg 40(12):1373–1376
Hoelzle F, Klein M, Schwerdtner O, Lueth T, Albrecht J, Hosten N, Felix R, Bier J (2001) Intraoperative computed tomography with the mobile CT Tomoscan M during surgical treatment of orbital fractures. Int J Oral Maxillofac Surg 30(1):26–31
Stanley RB (1999) Use of intraoperative computed tomography during repair of orbitozygomatic fractures. Arch Facial Plast Surg 1(1):19–24
Stuck BA, Hülse R, Barth TJ (2012) Intraoperative cone beam computed tomography in the management of facial fractures. Int J Oral Maxillofac Surg 41(10):1171–1175
Shaye DA, Tollefson TT, Strong EB (2015) Use of intraoperative computed tomography for maxillofacial reconstructive surgery. JAMA Facial Plast Surg 17(2):113–119
Singh M, Ricci JA, Caterson EJ (2015) Use of intraoperative computed tomography for revisional procedures in patients with complex maxillofacial trauma. Plast Reconstr Surg Glob Open 3(7):e463
Hatamleh MM, Yeung E, Osher J, Huppa C (2017) Novel treatment planning of hemimandibular hyperplasia by the use of three-dimensional computer-aided-design and computer-aided-manufacturing technologies. J Craniofac Surg 28(3):764–767
Mottini M, Seyed Jafari SM, Shafighi M, Schaller B (2016) New approach for virtual surgical planning and mandibular reconstruction using a fibula free flap. Oral Oncol 59:e6–e9
Li P, Zhou ZW, Ren JY, Zhang Y, Tian WD, Tang W (2016) Accuracy of three-dimensional facial soft tissue simulation in post-traumatic zygoma reconstruction. Int J Oral Maxillofac Surg 45(12):1665–1670
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Goguet, Q., Lee, S.H., Longis, J. et al. Intraoperative imaging and navigation with mobile cone-beam CT in maxillofacial surgery. Oral Maxillofac Surg 23, 487–491 (2019). https://doi.org/10.1007/s10006-019-00765-2
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DOI: https://doi.org/10.1007/s10006-019-00765-2