title: Assessment of the OsteoMark-Navigation System for Oral and Maxillofacial Surgery.
abstract: OBJECTIVE
  To assess the accuracy of a novel navigation system for maxillofacial surgery using human cadavers and a live minipig model.
  
  
  METHODS
  We tested an electromagnetic tracking system (OsteoMark-Navigation) that uses simple sensors to determine the position and orientation of a hand-held pencil-like marking device. The device can translate 3-dimensional computed tomographic data intraoperatively to allow the surgeon to localize and draw a proposed osteotomy or the resection margins of a tumor on bone. The accuracy of the OsteoMark-Navigation system in locating and marking osteotomies and screw positions in human cadaver heads was assessed. In group 1 (n = 3, 6 sides), OsteoMark-Navigation marked osteotomies and screw positions were compared to virtual treatment plans. In group 2 (n = 3, 6 sides), marked osteotomies and screw positions for distraction osteogenesis devices were compared with those performed using fabricated guide stents. Three metrics were used to document the precision and accuracy. In group 3 (n = 1), the system was tested in a standard operating room environment.
  
  
  RESULTS
  For group 1, the mean error between the points was 0.7 mm (horizontal) and 1.7 mm (vertical). Compared with the posterior and inferior mandibular border, the mean error was 1.2 and 1.7 mm, respectively. For group 2, the mean discrepancy between the points marked using the OsteoMark-Navigation system and the surgical guides was 1.9 mm (range 0 to 4.1). The system maintained accuracy on a live minipig in a standard operating room environment.
  
  
  CONCLUSIONS
  Based on this research OsteoMark-Navigation is a potentially powerful tool for clinical use in maxillofacial surgery. It has accuracy and precision comparable to that of existing clinical applications.
authors: Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA. Electronic address: zpeacock@partners.org.
authors: Zachary S
authors: ZS
authors: Peacock
authors: Principle Research Scientist, Physical Sciences, Inc, Andover, MA.
authors: John C
authors: JC
authors: Magill
authors: Masters Student, University of Massachusetts Boston; Research Fellow, Massachusetts General Hospital, Boston, MA.
authors: Brad J
authors: BJ
authors: Tricomi
authors: Principle Scientist, Physical Sciences, Inc, Andover, MA.
authors: Brian A
authors: BA
authors: Murphy
authors: Physical Sciences, Inc, Andover, MA.
authors: Vladimir
authors: V
authors: Nikonovskiy
authors: Software Engineer, Assistant Professor, Department of Radiology, Harvard Medical School; Director, Surgical Navigation and Robotics Laboratory, Brigham and Women's Hospital, Boston, MA.
authors: Nobuhiko
authors: N
authors: Hata
authors: Research Associate, Surgical Navigation and Robotics Laboratory, Brigham and Women's Hospital, Boston, MA.
authors: Laurent
authors: L
authors: Chauvin
authors: Associate Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.
authors: Maria J
authors: MJ
authors: Troulis
mesh_terms: D000818:Animals; D002102:Cadaver; D006801:Humans; D015203:Reproducibility of Results; D013515:Surgery, Oral / Q000295:instrumentation*; D013552:Swine; D013556:Swine, Miniature