Applications of Surgical Navigational Systems for Craniofacial Bone-Anchored Implant Placement

The following case reports describe the use of computer-assisted image-guided surgery to plan and place craniofacial bone-anchored implants (CBAI) for facial prosthetic reconstructions. During virtual planning, the soft tissue and bone visualizations are segmented from spiral computed tomography data and the patient's normal anatomy is mirrored onto the skull of the defect side, thus providing the ability to visualize the future prosthetic form. CBAI are planned in the anatomical area that leads to the best cosmetic results. Bone quantity is directly assessed at the surgical sites with the integrated instrumentation while the clinician navigates within the images and virtual planning scheme in real time. The aim of this report is to show a technique that incorporates computer-assisted image-guided surgery into the preoperative planning and surgical placement of CBAI. The use of this technology to plan and place implants in the most ideal location for facial prosthetic treatment eliminated the need for a conventional or prototyped surgical guide. Keywords: anaplastology, auricular prosthesis, computer-assisted image-guided surgery, craniofacial bone-anchored implant, navigation, preoperative planning