Image-guided bone resection as a prospective alternative to cutting templates—A preliminary study

Abstract

Objective: To evaluate the accuracy of craniomaxillofacial resections performed with an image-guided surgical sagittal saw.

Material and methods: Twenty-four craniomaxillofacial resections were performed using an image-guided sagittal saw. Surgical outcomes were compared with a preoperative virtual plan in terms of the resected bone volume, control point position and osteotomy trajectory angle. Each measurement was performed twice by two independent observers.

Results: The best convergence between the planned and actual bone resection was observed for the orbital region (6.33 ± 4.04%). The smallest mean difference between the preoperative and postoperative control point positions (2.00 ± 0.66 mm) and the lowest mean angular deviation between the virtual and actual osteotomy (5.49 ± 3.17 degrees) were documented for the maxillary region. When all the performed procedures were analyzed together, mean difference between the planned and actual bone resection volumes was 9.48 ± 4.91%, mean difference between the preoperative and postoperative control point positions amounted to 2.59 ± 1.41 mm, and mean angular deviation between the planned and actual osteotomy trajectory equaled 8.21 ± 5.69 degrees.

Conclusion: The results of this study are encouraging but not fully satisfactory. If further improved, the hereby presented navigation technique may become a valuable supporting method for craniomaxillofacial resections.

Keywords: Bone-cutting templates; Computer-assisted surgery; Craniomaxillofacial resection; Image-guided surgery; Intraoperative navigation; Virtual surgical planning.