Computer-assisted surgery (CAS) in facial bipartition surgery

Publication date: Available online 28 December 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Matthias Schlund, Arnaud Paré, Aline Joly, Boris Laure
IntroductionFrontonasal dysplasia or median cleft syndrome is a rare condition, often associated with transverse maxillary deficiency for which facial bipartition is the proper surgical treatment. In this technical note, we describe the use and efficacy of three-dimensional virtual surgical planning and patient-specific cutting guides in facial bipartition.Material & MethodsAn 11-year-old boy presented with frontonasal dysplasia and a midline facial cleft. Computed tomography (CT) scanning revealed that intercanthal distance was 40 mm and the maxillary width at the second molar level was 46.2 mm. The osteotomies, amount of bone removal, and movement of the osteotomized bone were planned virtually based on CT findings: the intended postoperative intercanthal distance and maxillary width were 25.5 and 49.6 mm, respectively. Customized cutting guides and titanium miniplates were manufactured. Postoperative CT showed an intercanthal distance of 25.5 mm and a maxillary width of 49.7 mm.DiscussionThe intercanthal distances and maxillary widths were similar between the simulation and postoperative CT images, confirming the accuracy and utility of computer-assisted surgery in facial bipartition.



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