Real-time image-guided recontouring in the management of craniofacial fibrous dysplasia.

OBJECTIVE: This report presents our experience using computer-aided recontouring in the surgical management of complex craniofacial fibrous dysplasia with the use of a navigation system developed by the authors.

STUDY DESIGN: A total of 21 patients (9 men and 12 women) with craniofacial fibrous dysplasia and mean age of 23 years (range, 17-32 years) were included in this study from 2007 to 2012. By creating a mirror image of the unaffected side on the affected side as a virtual treatment template, we completed the recontouring procedures in real time with the aid of the navigation system that we developed (Accu-Navi). The surgical outcome was assessed by superimposing the postoperative computed tomography (CT) images onto the preoperative CT images.

RESULTS: The precise preoperative simulation and intraoperative navigation enabled the surgeon to complete the recontouring procedure visually. Postoperative CT was compared with the preoperative plan, yielding an average discrepancy of <1.0 mm. Postoperative follow-up found that both facial aesthetics and patient satisfaction improved remarkably.

CONCLUSIONS: Navigation-guided recontouring shows benefits in improving accuracy and safety for this complicated procedure.