Major mandibular surgical procedures as an indication for intraoperative imaging.
OBJECTIVE
This study investigated 3-dimensional (3D) imaging with intraoperative cone beam computed tomography (CBCT) in major mandibular reconstruction procedures.


METHODS
The study group was comprised of 125 patients (83 males, 42 females) admitted for surgical treatment of the mandible. The patients ranged in age from 3 months to 91 years (average age, 40.72 +/- 22.843 years). Surgical procedures of the mandible were subdivided into repair of body fractures (17 patients), angle fractures (21 patients), condylar fractures (14 patients), and multiple fractures (30 patient). In addition, the study group included 21 patients undergoing orthognatic surgery and 22 undergoing reconstructive surgery on the mandible. Intraoperatively, 3D images were generated with a mobile CBCT scanner (Arcadis Orbic 3D; Siemens Medical Solutions, Erlangen, Germany).


RESULTS
During open reduction of mandibular fractures, not all fracture sites can be readily exposed for direct visual control. For example, the lingual cortical bone of the mandible is difficult to assess intraoperatively. This structure and others can be effectively visualized using the 3D mode of CBCT. Furthermore, screw placement can be evaluated, specifically in insertions near the alveolar nerve. The intraoperative acquisition of the data sets is uncomplicated, and the image quality is sufficient to allow evaluation of the postoperative result in all cases.


CONCLUSIONS
Intraoperative CBCT has proven to be a reliable imaging technique for providing visual control during major mandibular procedures.
Pohlenz
Philipp
P
Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ppohlenz@uke.uni-hamburg.de
Blessmann
Marco
M
Blake
Felix
F
Gbara
Ali
A
Schmelzle
Rainer
R
Heiland
Max
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D054893:Cone-Beam Computed Tomography / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008334:Mandible / Q000601:surgery*; D008337:Mandibular Fractures / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods