TY - JOUR
T1 - Evaluating the accuracy of resection planes in mandibular surgery using a preoperative, intraoperative, and postoperative approach
AU - Brouwer de Koning, S. G.
AU - ter Braak, T. P.
AU - Geldof, F.
AU - van Veen, R. L. P.
AU - van Alphen, M. J. A.
AU - Karssemakers, L. H. E.
AU - Schreuder, W. H.
AU - Karakullukcu, M. B.
N1 - Funding Information: The Netherlands Cancer Institute received a research grant from ATOS Medical Sweden , which contributes to the existing infrastructure for health-related, quality-of-life research in the Department of Head and Neck Oncology and Surgery. In addition, the research was partly funded by the Verwelius Foundation (Huizen, the Netherlands). Publisher Copyright: © 2020 International Association of Oral and Maxillofacial Surgeons
PY - 2021/3
Y1 - 2021/3
N2 - In mandibular surgery, three-dimensionally printed patient-specific cutting guides are used to translate the preoperative virtually planned resection planes to the operating room. This study was performed to determine whether cutting guides are positioned according to the virtual plan and to compare the intraoperative position of the cutting guide with the resection performed. Nine patients were included. The exact positions of the resection planes were planned virtually and a patient-specific cutting guide was designed and printed. After surgical placement of the cutting guide, intraoperative cone beam computed tomography (CBCT) was performed. Postoperative CT was used to obtain the final resection planes. Distances and yaw and pitch angles between the preoperative, intraoperative, and postoperative resection planes were calculated. Cutting guides were positioned on the mandible with millimetre accuracy. Anterior osteotomies were performed more accurately than posterior osteotomies (intraoperatively positioned and final resection planes differed by 1.2 ± 1.0 mm, 4.9 ± 6.6°, and 1.8 ± 1.5°, respectively, and by 2.2 ± 0.9 mm, 9.3 ± 9°, and 8.3 ± 6.5° respectively). Differences between intraoperatively planned and final resection planes imply a directional freedom of the saw through the saw slots. Since cutting guides are positioned with millimetre accuracy compared to the virtual plan, the design of the saw slots in the cutting guides needs improvement to allow more accurate resections.
AB - In mandibular surgery, three-dimensionally printed patient-specific cutting guides are used to translate the preoperative virtually planned resection planes to the operating room. This study was performed to determine whether cutting guides are positioned according to the virtual plan and to compare the intraoperative position of the cutting guide with the resection performed. Nine patients were included. The exact positions of the resection planes were planned virtually and a patient-specific cutting guide was designed and printed. After surgical placement of the cutting guide, intraoperative cone beam computed tomography (CBCT) was performed. Postoperative CT was used to obtain the final resection planes. Distances and yaw and pitch angles between the preoperative, intraoperative, and postoperative resection planes were calculated. Cutting guides were positioned on the mandible with millimetre accuracy. Anterior osteotomies were performed more accurately than posterior osteotomies (intraoperatively positioned and final resection planes differed by 1.2 ± 1.0 mm, 4.9 ± 6.6°, and 1.8 ± 1.5°, respectively, and by 2.2 ± 0.9 mm, 9.3 ± 9°, and 8.3 ± 6.5° respectively). Differences between intraoperatively planned and final resection planes imply a directional freedom of the saw through the saw slots. Since cutting guides are positioned with millimetre accuracy compared to the virtual plan, the design of the saw slots in the cutting guides needs improvement to allow more accurate resections.
KW - intraoperative CBCT
KW - mandibulectomy
KW - patient-specific cutting guides
KW - tumour resection margin
KW - virtual surgical planning
UR - http://www.scopus.com/inward/record.url?scp=85087996115&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijom.2020.06.013
DO - https://doi.org/10.1016/j.ijom.2020.06.013
M3 - Article
C2 - 32682645
SN - 0901-5027
VL - 50
SP - 287
EP - 293
JO - International Journal of Oral and Maxillofacial Surgery
JF - International Journal of Oral and Maxillofacial Surgery
IS - 3
ER -