Accuracy of the Computer-Aided Surgical Simulation (CASS) System in the Treatment of Patients With Complex Craniomaxillofacial Deformity: A Pilot Study
Purpose
Current surgical planning methods are usually not adequate for the treatment of patients with complex craniomaxillofacial (CMF) deformities. To this end, we have developed a 3-dimensional (3D) computer-aided surgical simulation (CASS) planning method for the treatment of patients with complex CMF deformities. The purpose of this pilot study was to evaluate the accuracy of this technique in the treatment of patients with complex CMF deformities.
Patients and Methods
Five patients with complex CMF deformities were enrolled. Surgeries were planned with the CASS planning method. Surgical plans were transferred to patients at the time of surgery via computer-generated splints. After surgery, outcome evaluation was completed by first superimposing the postoperative computed tomography (CT) model onto the planned model, and then measuring the differences between planned and actual outcomes. The criteria used to determine the accuracy of the technique were as follows: a linear difference between planned and actual outcomes of less than 2 mm, and an angular difference of less than 4°.
Results
All patients underwent surgery as planned. With the use of CASS planning, medians of the differences between planned and actual postoperative outcomes were limited to 0.9 mm and 1.7°.
Conclusion
The results of this pilot study are promising. They will be used as the basis of calculations needed to determine the sample size for a larger and more comprehensive study that will be undertaken to assess the accuracy of CASS planning methods.
⁎Director, Surgical Planning Laboratory, Department of Oral and Maxillofacial Surgery, The Methodist Hospital Research Institute, Houston, TX.
†Chairman, Department of Oral and Maxillofacial Surgery, The Methodist Hospital Research Institute, Houston, TX.
‡Professor, Division of Pediatric Plastic Surgery, Department of Surgery, University of Texas Houston Health Science Center, Houston, TX.
§President and Chief Technical Officer, Medical Modeling LLC, Golden, CO
∥Professor, Departments of Pediatrics and Obstetrics and Gynecology, University of Texas Houston Health Science Center, Houston, TX.
¶Doctoral Student, Department of Bioengineering, Rice University, Houston, TX.
#Assistant Professor, Department of Bioengineering, Rice University, Houston, TX.
Address correspondence and reprint requests to Dr Xia: Department of Oral and Maxillofacial Surgery, The Methodist Hospital Research Institute, 6560 Fannin Street, Suite 1228, Houston, TX 77096
This work was partially supported by NIH/NIDCR grant 1 R41 DE016171-01, UT–Houston Comprehensive Research Training Program 5 T32 DE015355-01 (NIH), and UT–Houston Medical School UCRC grant M01 RR002558 (NIH).
ABSTRACT