Computer modeling and intraoperative navigation in maxillofacial surgery

Purpose: Recent advances in computer-modeling software allow reconstruction of facial symmetry in a virtual environment. This study evaluates the use of preoperative computer modeling and intraoperative navigation to guide reconstruction of the maxillofacial skeleton. Methods: Three patients with traumatic maxillofacial deformities received preoperative, thin-cut axial CT scans. Three-dimensional reconstructions, virtual osteotomies, and bony reductions were performed using MIMICS planning software (Materialise, Ann Arbor, MI). The original and "repaired" virtual datasets were then imported into an intraoperative navigation system and used to guide the surgical repair. Results: Postoperative CT scans and photographs reveal excellent correction of enophthalmos to within 1 mm in patient 1, significant improvement in symmetry of the nasoethmoid complex in patient 2, and reconstruction of the zygomaticomaxillary complex location to within 1 mm in patient 3. Conclusion: Computer modeling and intraoperative navigation is a relatively new tool that can assist surgeons with reconstruction of the maxillofacial skeleton.