Effect of digital template in the assistant of a giant condylar osteochondroma resection.
OBJECTIVE
Exostosis osteochondroma is usually resected with the whole condyle even part of it is not involved. This study was to report the effect of using digital template in the assistant of resection while protecting the uninvolved condyle.


METHODS
We used computer-aided design technique in the assistant of making preoperative plan of a patient with giant condylar osteochondroma of exogenous type, including determining the boundary between the tumor and the articular surface of condyle, and designing the virtual tumor resection plane, surgical approach, and remove-out path of the tumor. The digital osteotomy template was made by rapid prototyping technique based on the preoperative plan. Postoperative CT scan was performed and merged with the preoperative CT by the Proplan 1.3 system to evaluate the accuracy of surgical resection with the guide of digital template.


RESULTS
The osteotomy template was attached to the lateral surface of condyle accurately, and the tumor was removed totally by the guide of the template without injuries to adjacent nerves and vessels. Postoperative CT showed that the osteochondroma was removed completely and the unaffected articular surface of condyle was preserved well. The merging of postoperative and preoperative CT by Proplan 1.3 system showed the outcome of the operation matched with the preoperative planning quite well with an error of 0.92 mm. There was no sign of recurrence after 6 months of follow-up.


CONCLUSIONS
The application of digital template could improve the accuracy of the giant condylar tumor resection and help to preserve the uninvolved condyle. The use of digital template could reduce injuries to the nerves and vessels as well as save time for the operation.
From the *Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai; and †School of Mechanical and Power Engineering, Shanghai Jiao Tong University, Shanghai, China.
Guo
G
Bai
Dongmei
D
He
Chi
C
Yang
Chuan
C
Lu
Dong
D
Huang
Minjie
M
Chen
Jianbing
J
Yuan
D000328:Adult; D001182:Arthroscopy / Q000379:methods; D003198:Computer Simulation; D017076:Computer-Aided Design; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008335:Mandibular Condyle / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000601:surgery*; D015831:Osteochondroma / Q000601:surgery*; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods; D010347:Patient Care Planning; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014584:User-Computer Interface