title: Image-guided bone resection as a prospective alternative to cutting templates—A preliminary study.
abstract: OBJECTIVE
  To evaluate the accuracy of craniomaxillofacial resections performed with an image-guided surgical sagittal saw.
  
  
  METHODS
  Twenty-four craniomaxillofacial resections were performed using an image-guided sagittal saw. Surgical outcomes were compared with a preoperative virtual plan in terms of the resected bone volume, control point position and osteotomy trajectory angle. Each measurement was performed twice by two independent observers.
  
  
  RESULTS
  The best convergence between the planned and actual bone resection was observed for the orbital region (6.33 ± 4.04%). The smallest mean difference between the preoperative and postoperative control point positions (2.00 ± 0.66 mm) and the lowest mean angular deviation between the virtual and actual osteotomy (5.49 ± 3.17 degrees) were documented for the maxillary region. When all the performed procedures were analyzed together, mean difference between the planned and actual bone resection volumes was 9.48 ± 4.91%, mean difference between the preoperative and postoperative control point positions amounted to 2.59 ± 1.41 mm, and mean angular deviation between the planned and actual osteotomy trajectory equaled 8.21 ± 5.69 degrees.
  
  
  CONCLUSIONS
  The results of this study are encouraging but not fully satisfactory. If further improved, the hereby presented navigation technique may become a valuable supporting method for craniomaxillofacial resections.
authors.affiliation: Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 Street, 02-781 Warsaw, Poland; Department of Plastic, Reconstructive and Aesthetic Surgery, Norbert Barlicki Memorial Hospital, Kopcinskiego 22 Street, 90-153 Lodz, Poland. Electronic address: pietruski.piotr@gmail.com.
authors.forename: Piotr
authors.initials: P
authors.lastname: Pietruski
authors.affiliation: Department of Biomedical Engineering, Mechatronics and Theory of Mechanisms, Wroclaw University of Technology, Lukasiewicza 7/9 Street, 50-371 Wroclaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Majak
authors.affiliation: Department of Biomedical Engineering, Mechatronics and Theory of Mechanisms, Wroclaw University of Technology, Lukasiewicza 7/9 Street, 50-371 Wroclaw, Poland.
authors.forename: Ewelina
authors.initials: E
authors.lastname: Światek-Najwer
authors.affiliation: Department of Biomedical Engineering, Mechatronics and Theory of Mechanisms, Wroclaw University of Technology, Lukasiewicza 7/9 Street, 50-371 Wroclaw, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Popek
authors.affiliation: Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 Street, 02-781 Warsaw, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Jaworowski
authors.affiliation: Department of Biomedical Engineering, Mechatronics and Theory of Mechanisms, Wroclaw University of Technology, Lukasiewicza 7/9 Street, 50-371 Wroclaw, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Zuk
authors.affiliation: Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5 Street, 02-781 Warsaw, Poland.
authors.forename: Filip
authors.initials: F
authors.lastname: Nowakowski
mesh_terms: D000539:Alveolar Process / Q000601:surgery; D017076:Computer-Aided Design; D005147:Facial Bones / Q000601:surgery*; D057918:Fiducial Markers; D005624:Frontal Bone / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008437:Maxilla / Q000601:surgery; D008953:Models, Anatomic; D009915:Orbit / Q000601:surgery; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D010347:Patient Care Planning; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014584:User-Computer Interface
keywords: Bone-cutting templates; Computer-assisted surgery; Craniomaxillofacial resection; Image-guided surgery; Intraoperative navigation; Virtual surgical planning