Use of intraoperative computed tomography for maxillofacial reconstructive surgery

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

IMPORTANCE: Intraoperative computed tomography (CT) provides surgeons with real-time feedback during maxillofacial trauma and reconstructive surgery, which can affect intraoperative decision making. OBJECTIVES: To evaluate the time needed to perform intraoperative CT scans during maxillofacial surgery, determine any trend toward shorter total scan times as experience is gained with the technique, and identify the characteristics of cases that required intraoperative revision based on the results of intraoperative CT scanning. DESIGN, SETTING, AND PARTICIPANTS: A retrospective reviewwas completed for all maxillofacial reconstruction procedures that used intraoperative CT between January 1, 2012, and March 31, 2014. INTERVENTIONS: Patients were cared for by the routine practice pattern of the authors. Intraoperative CT scans were obtained for all patients. MAIN OUTCOMES AND MEASURES: Time needed for intraoperative CT scanwas measured and trends were analyzed. Covariates included age, sex, complexity of fracture, procedure type, total scan time, surgeon, and need for intraoperative revision based on intraoperative CT findings. RESULTS: Thirty-eight cases were identified, including 30 males (79%) and 8 females (21%). The mean (SE) age was 37.4 (16.0) years (range, 7-75 years). Cases were defined as routine (18 [47%]) or complex (20 [53%]). Isolated orbital fractures were the most common fracture (23 [61%]) in both the routine (14 [78%]) and complex (9 [45%]) cases. The mean (SE) total scan time was 14.5 (4.9) minutes (range, 6-27 minutes) and did not differ based on complexity (P = .34). Intraoperative revisions were performed in 9 patients (24%) and were more common in complex (n = 8) than routine (n = 1) cases (P = .004). There was no reduction in total scan time during the study period (P = .22). The mean (SE) scan time for the most experienced surgeon was 3.78 (1.53) minutes shorter than for the other surgeons as a group (P = .02). CONCLUSIONS AND RELEVANCE: Current intraoperative CT scanning techniques are rapid, averaging 14.5 minutes per case. No decrease in total scan time was noted during the study; however, the surgeon most experienced with the CT software had the shortest total scan times. Intraoperative revisions were most common in complex cases. We recommend surgeons consider the use of intraoperative CT imaging for maxillofacial reconstruction, particularly in complex procedures. LEVEL OF EVIDENCE: NA.

Original languageEnglish (US)
Pages (from-to)113-119
Number of pages7
JournalJAMA Facial Plastic Surgery
Volume17
Issue number2
DOIs
StatePublished - Mar 1 2015

Fingerprint

Reconstructive Surgical Procedures
Oral Surgery
Tomography
Oral Surgical Procedures
Orbital Fractures
Surgeons
Decision Making

ASJC Scopus subject areas

  • Surgery

Cite this

Use of intraoperative computed tomography for maxillofacial reconstructive surgery. / Shaye, David A.; Tollefson, Travis Tate; Strong, E Bradley.

In: JAMA Facial Plastic Surgery, Vol. 17, No. 2, 01.03.2015, p. 113-119.

Research output: Contribution to journalArticle

@article{04f3be3e1274441db79786fec621b014,
title = "Use of intraoperative computed tomography for maxillofacial reconstructive surgery",
abstract = "IMPORTANCE: Intraoperative computed tomography (CT) provides surgeons with real-time feedback during maxillofacial trauma and reconstructive surgery, which can affect intraoperative decision making. OBJECTIVES: To evaluate the time needed to perform intraoperative CT scans during maxillofacial surgery, determine any trend toward shorter total scan times as experience is gained with the technique, and identify the characteristics of cases that required intraoperative revision based on the results of intraoperative CT scanning. DESIGN, SETTING, AND PARTICIPANTS: A retrospective reviewwas completed for all maxillofacial reconstruction procedures that used intraoperative CT between January 1, 2012, and March 31, 2014. INTERVENTIONS: Patients were cared for by the routine practice pattern of the authors. Intraoperative CT scans were obtained for all patients. MAIN OUTCOMES AND MEASURES: Time needed for intraoperative CT scanwas measured and trends were analyzed. Covariates included age, sex, complexity of fracture, procedure type, total scan time, surgeon, and need for intraoperative revision based on intraoperative CT findings. RESULTS: Thirty-eight cases were identified, including 30 males (79{\%}) and 8 females (21{\%}). The mean (SE) age was 37.4 (16.0) years (range, 7-75 years). Cases were defined as routine (18 [47{\%}]) or complex (20 [53{\%}]). Isolated orbital fractures were the most common fracture (23 [61{\%}]) in both the routine (14 [78{\%}]) and complex (9 [45{\%}]) cases. The mean (SE) total scan time was 14.5 (4.9) minutes (range, 6-27 minutes) and did not differ based on complexity (P = .34). Intraoperative revisions were performed in 9 patients (24{\%}) and were more common in complex (n = 8) than routine (n = 1) cases (P = .004). There was no reduction in total scan time during the study period (P = .22). The mean (SE) scan time for the most experienced surgeon was 3.78 (1.53) minutes shorter than for the other surgeons as a group (P = .02). CONCLUSIONS AND RELEVANCE: Current intraoperative CT scanning techniques are rapid, averaging 14.5 minutes per case. No decrease in total scan time was noted during the study; however, the surgeon most experienced with the CT software had the shortest total scan times. Intraoperative revisions were most common in complex cases. We recommend surgeons consider the use of intraoperative CT imaging for maxillofacial reconstruction, particularly in complex procedures. LEVEL OF EVIDENCE: NA.",
author = "Shaye, {David A.} and Tollefson, {Travis Tate} and Strong, {E Bradley}",
year = "2015",
month = "3",
day = "1",
doi = "10.1001/jamafacial.2014.1343",
language = "English (US)",
volume = "17",
pages = "113--119",
journal = "JAMA Facial Plastic Surgery",
issn = "2168-6076",
publisher = "American Medical Association",
number = "2",

}

TY - JOUR

T1 - Use of intraoperative computed tomography for maxillofacial reconstructive surgery

AU - Shaye, David A.

AU - Tollefson, Travis Tate

AU - Strong, E Bradley

PY - 2015/3/1

Y1 - 2015/3/1

N2 - IMPORTANCE: Intraoperative computed tomography (CT) provides surgeons with real-time feedback during maxillofacial trauma and reconstructive surgery, which can affect intraoperative decision making. OBJECTIVES: To evaluate the time needed to perform intraoperative CT scans during maxillofacial surgery, determine any trend toward shorter total scan times as experience is gained with the technique, and identify the characteristics of cases that required intraoperative revision based on the results of intraoperative CT scanning. DESIGN, SETTING, AND PARTICIPANTS: A retrospective reviewwas completed for all maxillofacial reconstruction procedures that used intraoperative CT between January 1, 2012, and March 31, 2014. INTERVENTIONS: Patients were cared for by the routine practice pattern of the authors. Intraoperative CT scans were obtained for all patients. MAIN OUTCOMES AND MEASURES: Time needed for intraoperative CT scanwas measured and trends were analyzed. Covariates included age, sex, complexity of fracture, procedure type, total scan time, surgeon, and need for intraoperative revision based on intraoperative CT findings. RESULTS: Thirty-eight cases were identified, including 30 males (79%) and 8 females (21%). The mean (SE) age was 37.4 (16.0) years (range, 7-75 years). Cases were defined as routine (18 [47%]) or complex (20 [53%]). Isolated orbital fractures were the most common fracture (23 [61%]) in both the routine (14 [78%]) and complex (9 [45%]) cases. The mean (SE) total scan time was 14.5 (4.9) minutes (range, 6-27 minutes) and did not differ based on complexity (P = .34). Intraoperative revisions were performed in 9 patients (24%) and were more common in complex (n = 8) than routine (n = 1) cases (P = .004). There was no reduction in total scan time during the study period (P = .22). The mean (SE) scan time for the most experienced surgeon was 3.78 (1.53) minutes shorter than for the other surgeons as a group (P = .02). CONCLUSIONS AND RELEVANCE: Current intraoperative CT scanning techniques are rapid, averaging 14.5 minutes per case. No decrease in total scan time was noted during the study; however, the surgeon most experienced with the CT software had the shortest total scan times. Intraoperative revisions were most common in complex cases. We recommend surgeons consider the use of intraoperative CT imaging for maxillofacial reconstruction, particularly in complex procedures. LEVEL OF EVIDENCE: NA.

AB - IMPORTANCE: Intraoperative computed tomography (CT) provides surgeons with real-time feedback during maxillofacial trauma and reconstructive surgery, which can affect intraoperative decision making. OBJECTIVES: To evaluate the time needed to perform intraoperative CT scans during maxillofacial surgery, determine any trend toward shorter total scan times as experience is gained with the technique, and identify the characteristics of cases that required intraoperative revision based on the results of intraoperative CT scanning. DESIGN, SETTING, AND PARTICIPANTS: A retrospective reviewwas completed for all maxillofacial reconstruction procedures that used intraoperative CT between January 1, 2012, and March 31, 2014. INTERVENTIONS: Patients were cared for by the routine practice pattern of the authors. Intraoperative CT scans were obtained for all patients. MAIN OUTCOMES AND MEASURES: Time needed for intraoperative CT scanwas measured and trends were analyzed. Covariates included age, sex, complexity of fracture, procedure type, total scan time, surgeon, and need for intraoperative revision based on intraoperative CT findings. RESULTS: Thirty-eight cases were identified, including 30 males (79%) and 8 females (21%). The mean (SE) age was 37.4 (16.0) years (range, 7-75 years). Cases were defined as routine (18 [47%]) or complex (20 [53%]). Isolated orbital fractures were the most common fracture (23 [61%]) in both the routine (14 [78%]) and complex (9 [45%]) cases. The mean (SE) total scan time was 14.5 (4.9) minutes (range, 6-27 minutes) and did not differ based on complexity (P = .34). Intraoperative revisions were performed in 9 patients (24%) and were more common in complex (n = 8) than routine (n = 1) cases (P = .004). There was no reduction in total scan time during the study period (P = .22). The mean (SE) scan time for the most experienced surgeon was 3.78 (1.53) minutes shorter than for the other surgeons as a group (P = .02). CONCLUSIONS AND RELEVANCE: Current intraoperative CT scanning techniques are rapid, averaging 14.5 minutes per case. No decrease in total scan time was noted during the study; however, the surgeon most experienced with the CT software had the shortest total scan times. Intraoperative revisions were most common in complex cases. We recommend surgeons consider the use of intraoperative CT imaging for maxillofacial reconstruction, particularly in complex procedures. LEVEL OF EVIDENCE: NA.

UR - http://www.scopus.com/inward/record.url?scp=84928479061&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928479061&partnerID=8YFLogxK

U2 - 10.1001/jamafacial.2014.1343

DO - 10.1001/jamafacial.2014.1343

M3 - Article

C2 - 25569785

AN - SCOPUS:84928479061

VL - 17

SP - 113

EP - 119

JO - JAMA Facial Plastic Surgery

JF - JAMA Facial Plastic Surgery

SN - 2168-6076

IS - 2

ER -