Expanding use of osseointegrated implantation using 3-dimensional surgical planning: a paradigm shift in dental reconstruction

Abstract BACKGROUND Adequate surgical planning includes a precise understanding of patient-specific anatomy and is a necessity for neurosurgeons. Although the use of virtual reality (VR) technology is emerging in surgical planning and education, few studies have examined the effectiveness of immersive VR during surgical planning using a modern head-mounted display. OBJECTIVE To investigate if and how immersive VR aids presurgical discussions of cerebrovascular surgery. METHODS A multiuser immersive VR system, BananaVisionTM, was developed and used during presurgical discussions in a prospective patient cohort undergoing cerebrovascular surgery. A questionnaire/interview was administered to multiple surgeons after the surgeries to evaluate the effectiveness of the VR system compared to conventional imaging modalities. An objective assessment of the surgeon's knowledge of patient-specific anatomy was also conducted by rating surgeons’ hand-drawn presurgical illustrations. RESULTS The VR session effectively enhanced surgeons’ understanding of patient-specific anatomy in the majority of cases (83.3%). An objective assessment of surgeons’ presurgical illustrations was consistent with this result. The VR session also effectively improved the decision-making process regarding minor surgical techniques in 61.1% of cases and even aided surgeons in making critical surgical decisions about cases involving complex and challenging anatomy. The utility of the VR system was rated significantly higher by trainees than by experts. CONCLUSION Although rated as more useful by trainees than by experts, immersive 3D VR modeling increased surgeons’ understanding of patient-specific anatomy and improved surgical strategy in certain cases involving challenging anatomy.

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Effect of 3-Dimensional Virtual Reality Models for Surgical Planning of Robotic-Assisted Partial Nephrectomy on Surgical Outcomes

JAMA Network Open ◽

10.1001/jamanetworkopen.2019.11598 ◽

2019 ◽

Vol 2 (9) ◽

pp. e1911598 ◽

Cited By ~ 9

Author(s):

Joseph D. Shirk ◽

David D. Thiel ◽

Eric M. Wallen ◽

Jennifer M. Linehan ◽

Wesley M. White ◽

...

Keyword(s):

Virtual Reality ◽

Partial Nephrectomy ◽

Surgical Outcomes ◽

Surgical Planning ◽

Robotic Assisted ◽

3 Dimensional ◽

Robotic Assisted Partial Nephrectomy

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Three-Dimensional Printing: Current Use in Rhinology and Endoscopic Skull Base Surgery

American Journal of Rhinology and Allergy ◽

10.1177/1945892419866319 ◽

2019 ◽

Vol 33 (6) ◽

pp. 770-781 ◽

Cited By ~ 2

Author(s):

Christopher M. Low ◽

Jonathan M. Morris ◽

Daniel L. Price ◽

Jane S. Matsumoto ◽

Janalee K. Stokken ◽

...

Keyword(s):

Patient Education ◽

3D Printing ◽

Skull Base ◽

Surgical Planning ◽

Skull Base Surgery ◽

Three Dimensional ◽

Educational Practice ◽

3 Dimensional ◽

Endoscopic Skull Base Surgery ◽

Surgical Teaching

Background In the discipline of rhinology and endoscopic skull base surgery (ESBS), 3-dimensional (3D) printing has found meaningful application in areas including preoperative surgical planning as well as in surgical education. However, its scope of use may be limited due to the perception among surgeons that there exists a prohibitively high initial investment in resources and time to acquire the requisite technical expertise. Nevertheless, given the ever decreasing cost of advancing technology coupled with the need to understand the complex spatial relationships of the paranasal sinuses and skull base, the use of 3D printing in rhinology and ESBS is poised to blossom. Objective Help the reader identify current or potential future uses of 3D printing technology relevant to their rhinologic clinical or educational practice. Methods A review of published literature relating to 3D printing in rhinology and ESBS was performed. Results Results were reviewed and organized into 5 overarching categories including an overview of the 3D printing process as well as applications of 3D printing including (1) surgical planning, (2) custom prosthetics and implants, (3) patient education, and (4) surgical teaching and assessment. Conclusion In the discipline of rhinology and ESBS, 3D printing finds use in the areas of presurgical planning, patient education, prosthesis creation, and trainee education. As this technology moves forward, these products will be more broadly available to providers in the clinical and educational setting. The possible applications are vast and have great potential to positively impact surgical training, patient satisfaction, and most importantly, patient outcomes.

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The Surgical White Matter Chassis: A Practical 3-Dimensional Atlas for Planning Subcortical Surgical Trajectories

Operative Neurosurgery ◽

10.1093/ons/opx177 ◽

2017 ◽

Vol 14 (5) ◽

pp. 469-482 ◽

Cited By ~ 13

Author(s):

Jonathan E Jennings ◽

Amin B Kassam ◽

Melanie B Fukui ◽

Alejandro Monroy-Sosa ◽

Srikant Chakravarthi ◽

...

Keyword(s):

White Matter ◽

Surgical Planning ◽

Diffusion Tensor ◽

Magnetic Resonance Images ◽

Practical Implementation ◽

Fiber Types ◽

3.0 Tesla ◽

3 Dimensional ◽

White Matter Anatomy

AbstractBACKGROUNDThe imperative role of white matter preservation in improving surgical functional outcomes is now recognized. Understanding the fundamental white matter framework is essential for translating the anatomic and functional literature into practical strategies for surgical planning and neuronavigation.OBJECTIVETo present a 3-dimensional (3-D) atlas of the structural and functional scaffolding of human white matter—ie, a “Surgical White Matter Chassis (SWMC)”—that can be used as an organizational tool in designing precise and individualized trajectory-based neurosurgical corridors.METHODSPreoperative diffusion tensor imaging magnetic resonance images were obtained prior to each of our last 100 awake subcortical resections, using a clinically available 3.0 Tesla system. Tractography was generated using a semiautomated deterministic global seeding algorithm. Tract data were conceptualized as a 3-D modular chassis based on the 3 major fiber types, organized along median and paramedian planes, with special attention to limbic and neocortical association tracts and their interconnections.RESULTSWe discuss practical implementation of the SWMC concept, and highlight its use in planning select illustrative cases. Emphasis has been given to developing practical understanding of the arcuate fasciculus, uncinate fasciculus, and vertical rami of the superior longitudinal fasciculus, which are often-neglected fibers in surgical planning.CONCLUSIONA working knowledge of white matter anatomy, as embodied in the SWMC, is of paramount importance to the planning of parafascicular surgical trajectories, and can serve as a basis for developing reliable safe corridors, or modules, toward the goal of “zero-footprint” transsulcal access to the subcortical space.

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Poster 190: 3-Dimensional Surgical Planning of Facial Reconstruction in Hemifacial Microsomia

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2007.06.459 ◽

2007 ◽

Vol 65 (9) ◽

pp. 43.e107-43.e108

Author(s):

John Lo

Keyword(s):

Surgical Planning ◽

Facial Reconstruction ◽

Hemifacial Microsomia ◽

3 Dimensional

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Virtual 3-Dimensional Computed Tomographic Surgical Planning for Severe Aortic Coarctation/Aneurysm in the Setting of Bicuspid Aortic Valve

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135116668336 ◽

2016 ◽

Vol 8 (1) ◽

pp. 99-100 ◽

Cited By ~ 1

Author(s):

Jerold S. Shinbane ◽

Serena Ghanshani ◽

Vaughn Starnes

Keyword(s):

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Aortic Coarctation ◽

Surgical Planning ◽

3 Dimensional ◽

Computed Tomographic

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Practical Application of Networks in Neurosurgery: Combined 3-Dimensional Printing, Neuronavigation, and Preoperative Surgical Planning

World Neurosurgery ◽

10.1016/j.wneu.2020.01.085 ◽

2020 ◽

Vol 137 ◽

pp. e126-e137

Author(s):

Rafael Romero-Garcia ◽

Yaara Erez ◽

Geoffrey Oliver ◽

Mallory Owen ◽

Sakinah Merali ◽

...

Keyword(s):

Surgical Planning ◽

Practical Application ◽

3 Dimensional ◽

Dimensional Printing

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Personalized quantification of facial normality: a machine learning approach

Scientific Reports ◽

10.1038/s41598-020-78180-x ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Osman Boyaci ◽

Erchin Serpedin ◽

Mitchell A. Stotland

Keyword(s):

Paradigm Shift ◽

Surgical Planning ◽

Outcome Measurement ◽

Great Promise ◽

Learning Approach ◽

Human Face ◽

Facial Image ◽

Perceptual Distance ◽

Machine Learning Approach ◽

Objective Tool

AbstractWhat is a normal face? A fundamental task for the facial reconstructive surgeon is to answer that question as it pertains to any given individual. Accordingly, it would be important to be able to place the facial appearance of a patient with congenital or acquired deformity numerically along their own continuum of normality, and to measure any surgical changes against such a personalized benchmark. This has not previously been possible. We have solved this problem by designing a computerized model that produces realistic, normalized versions of any given facial image, and objectively measures the perceptual distance between the raw and normalized facial image pair. The model is able to faithfully predict human scoring of facial normality. We believe this work represents a paradigm shift in the assessment of the human face, holding great promise for development as an objective tool for surgical planning, patient education, and as a means for clinical outcome measurement.

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