title: Use of virtual 3-dimensional surgery in post-traumatic craniomaxillofacial reconstruction.
abstract: Traumatic craniofacial injuries often present as difficult reconstructive challenges for maxillofacial surgeons. Reconstruction is often complicated by significant soft tissue loss, comminuted bony fragments, a tenuous blood supply, and wound contamination. For panfacial injuries, restoration of normal facial width, facial height, and sagittal projection may be difficult to achieve. Marked swelling may limit the surgeons' ability to palpate and recognize subtle bony defects and malunion. Furthermore, a true 3-dimensional assessment of bony alignment may not be possible with traditional surgical exposures to the craniofacial skeleton. This article builds on previous work that introduced the use of 3-dimensionally guided surgery for microvascular free-flap reconstruction of the craniofacial skeleton. Use of this technology improves the planning, timing, and overall precision of microvascular reconstructive surgery. Based on this experience, a similar approach to reconstructing patients with significant craniofacial trauma has been adopted.
authors.affiliation: Department of Surgery, Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY, USA.
authors.forename: Oren M
authors.initials: OM
authors.lastname: Tepper
authors.forename: Sarah
authors.initials: S
authors.lastname: Sorice
authors.forename: Gabriel N
authors.initials: GN
authors.lastname: Hershman
authors.forename: Pierre
authors.initials: P
authors.lastname: Saadeh
authors.forename: Jamie P
authors.initials: JP
authors.lastname: Levine
authors.forename: David
authors.initials: D
authors.lastname: Hirsch
mesh_terms: D000328:Adult; D017076:Computer-Aided Design; D003399:Craniotomy / Q000379:methods*; D005260:Female; D018460:Fractures, Comminuted / Q000601:surgery; D058752:Free Tissue Flaps / Q000098:blood supply; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008337:Mandibular Fractures / Q000601:surgery*; D008446:Maxillofacial Injuries / Q000601:surgery*; D008866:Microsurgery; D008875:Middle Aged; D008953:Models, Anatomic; D017090:Occlusal Splints; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D010347:Patient Care Planning; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000379:methods; D012887:Skull Fractures / Q000601:surgery; D013238:Stereotaxic Techniques; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface; D014948:Wounds, Gunshot / Q000601:surgery*