title: Computer-aided trauma simulation system with haptic feedback is easy and fast for oral-maxillofacial surgeons to learn and use.
abstract: OBJECTIVE
  Computer-assisted surgical (CAS) planning tools have become widely available in craniomaxillofacial surgery, but are time consuming and often require professional technical assistance to simulate a case. An initial oral and maxillofacial (OM) surgical user experience was evaluated with a newly developed CAS system featuring a bimanual sense of touch (haptic).
  
  
  METHODS
  Three volunteer OM surgeons received a 5-minute verbal introduction to the use of a newly developed haptic-enabled planning system. The surgeons were instructed to simulate mandibular fracture reductions of 3 clinical cases, within a 15-minute time limit and without a time limit, and complete a questionnaire to assess their subjective experience with the system. Standard landmarks and linear and angular measurements between the simulated results and the actual surgical outcome were compared.
  
  
  RESULTS
  After the 5-minute instruction, all 3 surgeons were able to use the system independently. The analysis of standardized anatomic measurements showed that the simulation results within a 15-minute time limit were not significantly different from those without a time limit. Mean differences between measurements of surgical and simulated fracture reductions were within current resolution limitations in collision detection, segmentation of computed tomographic scans, and haptic devices. All 3 surgeons reported that the system was easy to learn and use and that they would be comfortable integrating it into their daily clinical practice for trauma cases.
  
  
  CONCLUSIONS
  A CAS system with a haptic interface that capitalizes on touch and force feedback experience similar to operative procedures is fast and easy for OM surgeons to learn and use.
authors.affiliation: Department of Computer Science, Stanford University, Stanford, CA.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Schvartzman
authors.affiliation: Chief, Dental Service (160), Veterans Affairs Medical Center, San Francisco, CA.
authors.forename: Rebeka
authors.initials: R
authors.lastname: Silva
authors.affiliation: Professor, Department of Computer Science, Stanford University, Stanford, CA.
authors.forename: Ken
authors.initials: K
authors.lastname: Salisbury
authors.affiliation: Chief, Oral Medicine and Maxillofacial Surgery, Department of Surgery, Stanford University, Stanford, CA.
authors.forename: Dyani
authors.initials: D
authors.lastname: Gaudilliere
authors.affiliation: Chief, Oral Medicine and Maxillofacial Surgery, Department of Surgery, Stanford University, Stanford, CA. Electronic address: sgirod@stanford.edu.
authors.forename: Sabine
authors.initials: S
authors.lastname: Girod
mesh_terms: D059925:Anatomic Landmarks / Q000000981:diagnostic imaging; D001291:Attitude of Health Personnel; D002508:Cephalometry / Q000379:methods; D002680:Chin / Q000000981:diagnostic imaging; D003198:Computer Simulation; D005246:Feedback; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007575:Jaw, Edentulous / Q000000981:diagnostic imaging / Q000601:surgery; D008334:Mandible / Q000000981:diagnostic imaging; D008335:Mandibular Condyle / Q000000981:diagnostic imaging; D008336:Mandibular Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D010347:Patient Care Planning; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013515:Surgery, Oral / Q000193:education; D011795:Surveys and Questionnaires; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D014110:Touch / Q000502:physiology; D016896:Treatment Outcome; D014584:User-Computer Interface