Abstract
In orbital reconstruction, the acquired position of an orbital implant can be evaluated with the aid of intraoperative navigation. Feedback of the navigation system is only obtained after positioning of the implant: the implant's position is not tracked in real time during positioning. The surgeon has to interpret the navigation feedback and translate it to desired adjustments of the implant's position. In a previous study, a real-time implant-oriented navigation approach was introduced and the system's accuracy was evaluated. In this study, this real-time navigation approach was compared to a marker-based navigation approach in a preclinical set-up. Ten cadavers (20 orbital defects) were reconstructed twice, by two surgeons (total: 80 reconstructions). Implant positioning was significantly improved in the real-time implant-oriented approach in terms of roll (2.0° vs. 3.2°, P = 0.03), yaw (2.2° vs. 3.4°, P = 0.01) and translation (1.3 mm vs. 1.8 mm, P = 0.005). Duration of the real-time navigation procedure was reduced (median 4.5 min vs. 7.5 min). Subjective appreciation of the navigation technique was higher for real-time implant-oriented navigation (mean 7.5 vs. 9.0). Real-time implant-oriented navigation feedback provides real-time, intuitive feedback to the surgeon, which leads to improved implant positioning and shortens duration of the navigation procedure.
| Original language | English |
|---|---|
| Pages (from-to) | 678-685 |
| Number of pages | 8 |
| Journal | International Journal of Oral and Maxillofacial Surgery |
| Volume | 49 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 2020 |
Funding
The authors would like to acknowledge the work of N.H.J. Lobé from the department of Radiology in the design of the CT protocol and acquisition of the CT scans. We want to thank M. Clerkx and J.E. Lichtenberg, Department of Anatomy, for their assistance in the cadaver lab. We are grateful for the help of C. Kes, M. Rijpkema and M.M. Steenmetz from the tool shop of the AMC (Cluster III) in the design adjustments of the instrument. We want to thank M.D.J. Wolvers and R. Holman, Clinical Research Unit, for their advice on the statistical analyses used in this study. Finally, we would like to thank KLS Martin for providing the Smart Groove orbital implants used in this study, and Brainlab for making the Curve, navigation instruments and IGT Link license available for this study.
| Funders | Funder number |
|---|---|
| Department of Radiology, Weill Cornell Medical College |