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Published in: International Journal of Computer Assisted Radiology and Surgery 10/2020

28-07-2020 | Original Article

A surgical navigated cutting guide for mandibular osteotomies: accuracy and reproducibility of an image-guided mandibular osteotomy

Authors: Timon Peter ter Braak, Susan Gijsbertje Brouwer de Koning, Maarten Jan Antony van Alphen, Ferdinand van der Heijden, Willem Hans Schreuder, Robert Leonardus Petrus van Veen, Munir Baris Karakullukcu

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 10/2020

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Abstract

Purpose

3D-printed cutting guides are the current standard to translate the virtual surgery plan to the intraoperative setting. The production of these patient-specific cutting guides is time-consuming and costly, and therefore, alternative approaches are currently subject of research. The aim of this study was to assess the accuracy and reproducibility of using a novel electromagnetic (EM) navigated surgical cutting guide to perform virtually planned osteotomies in mandible models.

Methods

A novel 3D navigated cutting guide (dubbed Bladerunner) was designed and evaluated with a total of 20 osteotomies, performed on plaster mandibular models according to preoperative planning using EM navigation. The pre- and postoperative scans were registered, and the difference between the preoperatively planned osteotomy and the performed osteotomy was expressed as the distance between the planned and performed cutting planes, and the yaw and roll angles between the planes.

Results

The mean difference in distance between the planned osteotomy and performed osteotomy was 1.1 mm (STD 0.6 mm), the mean yaw was 1.8° (STD 1.4°), and mean roll was 1.6° (STD 1.3°).

Conclusion

The proposed EM navigated cutting guide for mandibular osteotomies demonstrated accurate positioning of the cutting plane according to the preoperative virtual surgical plan with respect to distance, yaw and roll angles. This novel approach has the potential to make the use of 3D-printed cutting guides obsolete, thereby decreasing the interval between diagnosis and surgery, reduce cost and allow for adaptation of the virtual plan in case of rapid tumor proliferation or unanticipated in situ deviations from the preoperative CT/MR imaging.

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Literature
11.
go back to reference Brouwer de Koning SG, ter Braak TP, Geldof F, van Veen RLP, van Alphen MJA, Karssemakers LHE, Ruers TJM, Schreuder WH, Karakullukcu MB (2019) Evaluating the accuracy of resection planes in mandibular surgery using a preoperative, intraoperative, and postoperative approach. Int J Oral Maxillofac Surg. https://doi.org/10.1016/j.ijom.2020.06.013CrossRef Brouwer de Koning SG, ter Braak TP, Geldof F, van Veen RLP, van Alphen MJA, Karssemakers LHE, Ruers TJM, Schreuder WH, Karakullukcu MB (2019) Evaluating the accuracy of resection planes in mandibular surgery using a preoperative, intraoperative, and postoperative approach. Int J Oral Maxillofac Surg. https://​doi.​org/​10.​1016/​j.​ijom.​2020.​06.​013CrossRef
13.
Metadata
Title
A surgical navigated cutting guide for mandibular osteotomies: accuracy and reproducibility of an image-guided mandibular osteotomy
Authors
Timon Peter ter Braak
Susan Gijsbertje Brouwer de Koning
Maarten Jan Antony van Alphen
Ferdinand van der Heijden
Willem Hans Schreuder
Robert Leonardus Petrus van Veen
Munir Baris Karakullukcu
Publication date
28-07-2020
Publisher
Springer International Publishing
Published in
International Journal of Computer Assisted Radiology and Surgery / Issue 10/2020
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-020-02234-8

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