Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery
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J Craniomaxillofac Surg · Dec 2014
A ten year analysis of the traumatic maxillofacial and brain injury patient in Amsterdam: complications and treatment.
Maxillofacial trauma is often associated with injuries to the cranium, especially in high-energy trauma. The management of such cases can be challenging and requires close cooperation between oral and maxillofacial surgery and neurosurgical teams. There are few reports in the current literature describing the complications that develop in patients with maxillofacial trauma and traumatic brain injury (TBI). ⋯ Thirteen patients (36.1%) were transferred to a rehabilitation centre, a nursing home, or a home for the elderly. Nine patients (25%) completely recovered from their complications and 4 patients (11.1%) died after the trauma. This report provides useful data concerning the rate and type of complications that occur, and the multidisciplinary treatment that is required in traumatic maxillofacial and brain injury patients.
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J Craniomaxillofac Surg · Dec 2014
Case ReportsCranial reconstruction: 3D biomodel and custom-built implant created using additive manufacturing.
Additive manufacturing (AM) technology from engineering has helped to achieve several advances in the medical field, particularly as far as fabrication of implants is concerned. The use of AM has made it possible to carry out surgical planning and simulation using a three-dimensional physical model which accurately represents the patient's anatomy. AM technology enables the production of models and implants directly from a 3D virtual model, facilitating surgical procedures and reducing risks. ⋯ This work presents AM technologies which were applied to design and fabricate a biomodel and customized implant for the surgical reconstruction of a large cranial defect. A series of computed tomography data was obtained and software was used to extract the cranial geometry. The protocol presented was used to create an anatomic biomodel of the bone defect for surgical planning and, finally, the design and manufacture of the patient-specific implant.
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J Craniomaxillofac Surg · Dec 2014
Comparative StudyAugmented reality as an aid in maxillofacial surgery: validation of a wearable system allowing maxillary repositioning.
We present a newly designed, localiser-free, head-mounted system featuring augmented reality as an aid to maxillofacial bone surgery, and assess the potential utility of the device by conducting a feasibility study and validation. ⋯ We used a new localiser-free, head-mounted, wearable, stereoscopic, video see-through display to develop a useful strategy affording surgeons access to augmented reality information. Our device appears to be accurate when used to assist in waferless maxillary repositioning. Our results suggest that the method can potentially be extended for use with many surgical procedures on the facial skeleton. Further, our positive results suggest that it would be appropriate to proceed to in vivo testing to assess surgical accuracy under real clinical conditions.
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J Craniomaxillofac Surg · Dec 2014
Comparative StudyAn integrated orthognathic surgery system for virtual planning and image-guided transfer without intermediate splint.
Accurate surgical planning and transfer of the planning in orthognathic surgery are very important in achieving a successful surgical outcome with appropriate improvement. Conventionally, the paper surgery is performed based on a 2D cephalometric radiograph, and the results are expressed using cast models and an articulator. We developed an integrated orthognathic surgery system with 3D virtual planning and image-guided transfer. ⋯ The root mean square (RMS) difference between virtual surgery and conventional model surgery was 0.75 ± 0.51 mm for 12 patients. The RMS difference between virtual surgery and image-guidance results was 0.78 ± 0.52 mm, which showed no significant difference from the difference of conventional model surgery. The image-guided orthognathic surgery system integrated with virtual planning will replace physical model surgical planning and enable transfer of the virtual planning directly without the need for an intermediate splint.
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J Craniomaxillofac Surg · Dec 2014
Comparative StudyA comparison of free anterolateral thigh and latissimus dorsi flaps in soft tissue reconstruction of extensive defects in the head and neck region.
Tailoring the most suitable reconstructive approach to each patient remains challenging especially in the head and neck region. To compare the applicability of the latissimus dorsi (LD) and anterolateral thigh (ALT) flap, we retrospectively analyzed patients who had reconstruction of extensive and/or bulky composite tissue defects in the head and neck area. We performed 85 free tissue transfers (44 LD and 41 ALT flaps). ⋯ They largely meet the requirements of an ideal soft tissue flap in terms of versatility, skin texture and tissue stock. Both flaps can be raised with a double skin paddle. The advantages and disadvantages of each flap have to be weighed up against each other and both flaps should be in the repertoire of every microvascular surgeon.