title: A Multicenter Experience With Image-Guided Surgical Navigation: Broadening Clinical Indications in Complex Craniomaxillofacial Surgery.
abstract: OBJECTIVE
  Image-guided surgical navigation, or computed tomography (CT)-guided surgery, is a technology used by many specialties to reduce complications and improve surgical outcomes. Its use has become widespread in neurosurgical intracranial and otolaryngological skull base procedures. The authors hypothesize that CT image-guided surgical navigation has a wide scope of utility in complex craniomaxillofacial procedures. With time and experience, its use will further advance the safety and efficacy of craniomaxillofacial surgery.
  
  
  METHODS
  A multicenter retrospective study at the University of California-Los Angeles, New York University, University of Pittsburgh, and the University of Kansas Medical Center was conducted. All craniomaxillofacial procedures using CT image-guided surgical navigation were reviewed.
  
  
  RESULTS
  Twenty subjects were identified who underwent a total of 26 CT-guided navigation procedures (6 cases were bilateral). Subunits reconstructed included: the upper face (n = 5), middle face (n = 7), and lower face (n = 6). Two additional patients used CT navigation to reconstruct multiple facial subunits. In all 20 subjects, the image-guided system correctly identified the surgical anatomy to less than 2 mm. There were no perioperative complications. Long-term follow-up demonstrated no revisionary procedures were required to date.
  
  
  CONCLUSIONS
  Computed tomography-guided navigation is a safe and effective tool with multiple applications in craniomaxillofacial surgery. Indications for its use in complex craniomaxillofacial procedures continue to broaden. Further experience with this technology will continue to expand its clinical utility in craniomaxillofacial surgery.
authors.affiliation: *Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, KS †Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center, New York, NY ‡Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA §Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, Los Angeles, CA.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Andrews
authors.forename: Todd E
authors.initials: TE
authors.lastname: Thurston
authors.forename: Neil
authors.initials: N
authors.lastname: Tanna
authors.forename: P Niclas
authors.initials: PN
authors.lastname: Broer
authors.forename: Jamie P
authors.initials: JP
authors.lastname: Levine
authors.forename: Anand
authors.initials: A
authors.lastname: Kumar
authors.forename: James P
authors.initials: JP
authors.lastname: Bradley
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D019465:Craniofacial Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013515:Surgery, Oral / Q000379:methods*; D014057:Tomography, X-Ray Computed; D055815:Young Adult