Interdisciplinary Surgical Management of Multiple Facial Fractures With Image-Guided Navigation.

Purpose: To evaluate the effectiveness of interdisciplinary surgical management of multiple facial fractures with image-guided surgical navigation.

Patients And Methods: From 2011 through 2014, 36 patients with multiple facial fractures were enrolled in the study. With individual virtual 3-dimensional (3D) modeling, interdisciplinary planning and surgical simulation were carried out on an Accu-Navi software platform. Through an interactive collaboration among specialists, all patients underwent 1-stage open reduction under guidance of the navigation system. The outcome was assessed by superimposing the postoperative 3D computed tomographic (CT) model on the preoperative plan and clinical examination.

Results: Through the registration procedure, an accurate match between the actual intraoperative position and the CT images was achieved within a systematic error of 1 mm. The fractured bone segments were released and repositioned according to the preoperative plan and simulation with the aid of instrument- and probe-based navigation. All patients underwent uneventful healing without serious complications. Postoperative assessment of surgical intervention showed a quantitative discrepancy less than 2 mm (1.49 ± 0.27), showing a satisfactory concordance.

Conclusion: In the interdisciplinary surgical management of multiple facial fractures, image-guided surgical navigation, including preoperative planning, surgical simulation, postoperative assessment, and computer-assisted navigation, proved an optimal strategy and valuable option for this potentially complicated procedure.