Computer-Aided Surgical Simulation and Navigation in Reconstruction of Old Complicated Cranio-maxillofacial Fractures

Reconstruction of the old complicated craniomaxillofacial (CMF) fractures requires a precise and safe therapy to improve the functional and aesthetic outcome. In this paper, an image-guided simulation and navigation system was developed (Navi-CMFS)to improve the accuracy and reliability of the reconstruction surgery of the old complicated CMF fractures. Pre-operative planning and simulation based on 3-dimension (3D) model can provide enough 3D information of the patient. Intra-operative navigation can widen the surgeons’ vision field and locate the continually updated position of the instruments and the patient, to avoid injury to the important tissue. Clinical studies were conducted on 6 patients with complicated CMF fractures. Firstly, a virtual 3D skull model was reconstructed from pre-surgical image dataset information. In this virtual 3D model, surgeon moved or rotated the fractured bone and relocated it in a desired site according to the mirrored part from the unaffected side. After patient-to-image registration, the surgical instrument and patient were tracked in real-time by the optical tracking system during operation. In this way the old complicated CMF fractures were relocated satisfactorily guided by the virtual image. The results show that this system is proved to be essential helpful in reconstruction of the old complicated CMF fractures.