Computer modeling and navigation in maxillofacial surgery.

PURPOSE OF REVIEW: To review the accuracy and effectiveness of current technology available for computer-aided maxillofacial surgery.

RECENT FINDINGS: New developments in computer technology can help surgeons with preoperative planning and intraoperative navigation in the management of maxillofacial injuries.

SUMMARY: Computer-aided surgery is improving the surgical outcomes in maxillofacial reconstruction, particularly in complex cases. Several recent articles are presented that explore the clinical outcomes using computer-aided surgery, investigate the precision of various intraoperative optical navigation systems, compare several registration strategies and examine the impact of natural facial asymmetry on planning and reconstruction. In all cases, preoperative computed tomography (CT) data are imported to computer modeling programs in which virtual reconstructions can be performed. These reconstructions are then used by intraoperative navigation systems to guide the surgeon and increase the precision of surgical outcomes. Evaluation of various registration strategies used to orient navigation systems to patient anatomical markers demonstrates that the optimum strategy is dependent on injury type. Some degree of error when repairing maxillofacial injuries is negated by the fact that people have naturally asymmetrical craniofacial skeletons.