Improved 3D Osteotomy Planning in Cranio-maxillofacial Surgery

  • Stefan Zachow
  • Evgeny Gladilin
  • Hans-Florian Zeilhofer
  • Robert Sader
Conference paper
First Online:
Part of the Lecture Notes in Computer Science book series (LNCS, volume 2208)

Abstract

In this paper we present two clinical cases in maxillofacial surgery, where complex surgical interventions have been pre-operatively planned on 3D models of the patients’ heads. Our goal was to provide surgeons with an additional planning criterion, i.e. the prediction of the post-operative facial appearance. In our first study a two step mandibular distraction has been planned, and in the second one a bimaxillary operation with a high Le Fort I osteotomy of the maxilla according to Bell, as well as a sagittal split osteotomy on both sides of the mandible, according to Obwegeser-Dal Pont. Within our study we did focus on the three dimensional soft tissue simulation using finite element methods. For the provision of such a planning aid, concepts for an integrated 3D surgery planning system are proposed that are partially implemented and demonstrated.

Keywords

Computer-Assisted Cranio-Maxillofacial Surgery Osteotomy Osteodistraction Soft Tissue Prediction Finite-Element Methods 
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References

  1. [1]
    Cutting, C.; Bookstein, F.L.; Grayson, B. et’al.: Three-Dimensional Computer-Assisted Design of Craniofacial Surgical Procedures: Optimization and Interaction with Cephalometric and CT-Based Models. J. Plast. Reconstr. Surg. 77(6), pp. 877–885 (1986)Google Scholar
  2. [2]
    Yasuda, T.; Hashimoto, Y.; Yokoi, S. and Toriwaki, J.-J.: Computer System for Craniofacial Surgical Planning Based on CT Images. IEEE Trans. Med. Imag. 9(3), pp. 270–280 (1990)CrossRefGoogle Scholar
  3. [3]
    Pieper, S.: CAPS: Computer Aided Plastic Surgery. Ph.D. thesis, MIT (1991)Google Scholar
  4. [4]
    Altobelli, D.E.; Kikinis, R.; Mulliken, J.B. et al.: Computer-assisted three-dimensional planning in craniofacial surgery. J. Plast. Reconstr. Surg., Sep 92(4), pp. 576–587 (1993)CrossRefGoogle Scholar
  5. [5]
    Girod, S.; Keeve, E.; Girod, B.: Advances in interactive craniofacial surgery planning by 3D simulation and visualization. Int. J. Oral Maxillof. Surg. 24(1), pp 120–125 (1995)CrossRefGoogle Scholar
  6. [6]
    Koch, R.M.; Gross, M.H.; Carls, F.R. et al.: Simulating Facial Surgery Using Finite Element Models. Computer Graphics, Proc. ACM Siggraph, pp. 421–428 (1996)Google Scholar
  7. [7]
    Teschner, M.: Direct Computation of Soft-Tissue Deformation in Craniofacial Surgery Simulation. Ph.D. thesis, Friedrich-Alexander-Universität Erlangen-Nürnberg (2000)Google Scholar
  8. [8]
    Schutyser, F.; Van Cleynenbreugel, J.; Ferrant, M. et al.: Image-Based 3D Planning of Maxillofacial Distraction Procedures Including Soft Tissue Implications. In: Delp, S.L. et al. (eds.) Medical Image Computing and Computer-Assisted Intervention (MICCAI), pp. 999–1007 (2000)Google Scholar
  9. [9]
    Everett, P.C.; Seldin, E.B.; Troulis, M. et al.: A 3-D System for Planning and Simulating Minimally-Invasive Distraction Osteogenesis of the Facial Skeleton. In: Delp, S.L. et al. (eds.) Medical Image Computing and Computer-Assisted Intervention (MICCAI), pp. 1029–1039 (2000)Google Scholar
  10. [10]
    Bettega, G.; Payan, Y.; Mollard, B. et al.: A simulator for maxillofacial surgery integrating 3D cephalometry and orthodontia. J. Comp. Aid. Surg. 5(3), pp. 156–165 (2000)CrossRefGoogle Scholar
  11. [11]
    Zachow, S.; Gladilin, E.; Hege, H.-C. and Deuflhard, P.: Finite-Element Simulation of Soft Tissue Deformation. In: Lemke, H.U. et al. (eds.): Computer Assisted Radiology and Surgery, pp. 23–28 (2000)Google Scholar
  12. [12]
    Stalling, D.; Hege, H.C.; Zöckler, M. et. al.: Amira-An Advanced 3D Visualization and Modeling System, URL: http://amira.zib.de
  13. [13]
    Gladilin, E.; Zachow, S.; Deuflhard, P. and Hege, H.-C.: Validation of a Linear Elastic Model for Soft Tissue Prediction in Craniofacial Surgery. SPIE Medical Imaging, San Diego, (2001)Google Scholar
  14. [14]
    Gladilin, E.; Zachow, S.; Deuflhard, P. and Hege, H.-C.: A Biomechanical Model for Soft Tissue Simulation in Craniofacial Surgery. Medical Imaging and Augmented Reality, Hong Kong, China (2001)Google Scholar
  15. [15]
    Brief, J.; Hassfeld, S.; Däuber, S. et al.: 3D Norm Data: The first step towards Semiautomatic Virtual Craniofacial Surgery. J. Comp. Aid. Surg. 5(3), pp. 353–358 (2000)CrossRefGoogle Scholar
  16. [16]
    Zachow, S.; Lueth, T.C.; Stalling, D. et al.: Optimized Arrangement of Osseointegrated Implants: A Surgical Planning System for the Fixation of Facial Prostheses. In: Lemke, H.U. et al. (eds.): Computer Assisted Radiology and Surgery (CARS), pp. 942–946 (1999)Google Scholar
  17. [17]
    Hege, H.C.; Seebaβ, M.; Stalling, D.; Zöckler, M.: A Generalized Marching Cubes Algorithm Based On Non-Binary Classifications. ZIB Preprint SC-97-05 (1997)Google Scholar
  18. [18]
    Stalling, D.; Zöckler, M.; Hege, H.-C.: Interactive Segmentation of 3D Medical Images with Subvoxel Accuracy. In: Lemke, H.U. et al. (eds.), Computer Assisted Radiology and Surgery, pp. 137–142 (1989)Google Scholar
  19. [19]
    Jin, H. and Tanner, R.I.: Generation of Unstructured Tetrahedral Meshes by Advancing Front Technique. Int. J. Numer. Methods Eng. 36, pp. 1805–1823 (1993)MATHCrossRefGoogle Scholar
  20. [20]
    Duck, F.A.: Physical Properties of Tissue–A Comprehensive Reference Book. Academic Press, Chap. 5, pp. 151 ff. (1990)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • Stefan Zachow
    • 1
  • Evgeny Gladilin
    • 1
  • Hans-Florian Zeilhofer
    • 2
  • Robert Sader
    • 2
  1. 1.Konrad-Zuse-Zentrum für Informationstechnik Berlin (ZIB)Germany
  2. 2.Department of Oral & Maxillofacial SurgeryUniversity of TechnologyMunichGermany

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