Knowledge Acquisition and Construction of a RDF-Ontology for Computer-Assisted Surgery

The integration of surgical knowledge into virtual planning systems plays a key role in computer-assisted surgery. The knowledge is often implicitly contained in the implemented algorithms. However, a strict separation would be desirable for reasons of maintainability, reusability and readability. Along with the Department of Oral and Maxillofacial Surgery at Heidelberg University Hospital, we are working on the development of a virtual planning system for mandibular reconstruction. In this work we describe a process for the structured acquisition and representation of surgical knowledge for mandibular reconstruction. Based on the acquired knowledge, an RDF(S) ontology was created. The ontology is connected to the virtual planning system via a SPARQL interface. The described process of knowledge acquisition can be transferred to other surgical use cases. Furthermore, the developed ontology is characterised by a reusable and easily expandable data model.

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Computer-Assisted Navigation Surgery in Oral and Maxillofacial Surgery

Oral and Maxillofacial Surgery for the Clinician ◽

10.1007/978-981-15-1346-6_41 ◽

2021 ◽

pp. 841-862

Author(s):

Shintaro Sukegawa ◽

Takahiro Kanno

Keyword(s):

Maxillofacial Surgery ◽

Computer Assisted Surgery ◽

Oral And Maxillofacial Surgery ◽

Computer Assisted ◽

Navigation Systems ◽

Navigation Surgery ◽

Assisted Navigation ◽

Surgical Options ◽

Application Of Cas ◽

Patient Stress

AbstractComputer-assisted surgery (CAS) and navigation offers significant improvements in patient orientation and safety in every facet of our specialty of maxillofacial surgery. Ranging from precisely planned orthognathic procedures to the removal of foreign bodies requiring extremely flexible surgical options, and from minimally invasive dental implantology procedures to radical tumor resections of the skull base, they have made their mark for improving the procedure safety, predictability, and accuracy of surgery and options for intraoperative adaptations. In the future, the application of CAS is expected to further reduce operative risks and surgery time, accompanied by a considerable decrease in patient stress.Navigation systems are effective for delicate and accurate oral and maxillofacial surgery, neurosurgery, otolaryngology, and orthopedic surgery.This section presents an overview of available navigation systems and their applications with a focus on clinical utility and the solutions they offer for problems/challenges in the field of oral and maxillofacial surgery.

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Mandibular Reconstruction Using ProPlan CMF: A Review

Craniomaxillofacial Trauma & Reconstruction Open ◽

10.1055/s-0037-1606835 ◽

2017 ◽

Vol 1 (1) ◽

pp. s-0037-1606835 ◽

Cited By ~ 2

Author(s):

Ryo Sasaki ◽

Michael Rasse

Keyword(s):

Computer Assisted Surgery ◽

Mandibular Reconstruction ◽

Patient Specific ◽

Computer Assisted ◽

Planning Service ◽

Virtual Planning ◽

Surgical Guide ◽

Surgical Guides ◽

Computer Aided

ProPlan CMF (Depuy Synthes, Solothurn, Switzerland, and Materialise, Leuven, Belgium) is a computer-aided surgical virtual planning service using an online meeting with professional medical engineers and transfers patient-specific surgical guide to the virtual plan. Moreover, prebent reconstruction plates or patient-specific computer-aided manufacturing-fabricated reconstruction can also be used. This service started in 2011. Currently, it is widely used in Europe. Current status of mandibular reconstruction with ProPlan CMF vertical planning service with the surgical guide was reviewed. The accuracy was excellent in terms of contact of the osteotomized parts and the contact to the remaining skeleton. The authors found that currently, a small number of reports regarding the mandibular reconstruction with virtual planning service and surgical guides are available. These reports also have a small number of cases and short-term follow-up results. In this situation, this review revealed that (1) mainly the resection guides, cutting guides, and patient-specific mandible reconstruction plates were adequately well fitted to the surgical site intraoperatively, (2) the ischemic time might be more reduced than that of the conventional surgery (3) the accuracy of computer-assisted surgery in the mandibular reconstruction was clinically acceptable, and (4) condyle positions after the computer-assisted surgery was mainly normal. The higher additional cost than that of the conventional technique is presently an issue. Large-scale clinical studies and long-term follow-up studies are demanded.

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Mandibular Reconstruction with Bridging Customized Plate after Ablative Surgery for ONJ: A Multi-Centric Case Series

Applied Sciences ◽

10.3390/app112211069 ◽

2021 ◽

Vol 11 (22) ◽

pp. 11069

Author(s):

Salvatore Battaglia ◽

Francesco Ricotta ◽

Salvatore Crimi ◽

Rosalia Mineo ◽

Fabio Michelon ◽

...

Keyword(s):

Maxillofacial Surgery ◽

Case Series ◽

Mandibular Reconstruction ◽

Computer Assisted ◽

Virtual Planning ◽

Reconstructive Procedures ◽

Average Accuracy ◽

Ablative Surgery ◽

Cad Cam ◽

Safe Technique

Purpose: Computer-aided methods for mandibular reconstruction have improved both functional and morphological results in patients who underwent segmental mandibular resection. The purpose of this study is to evaluate the overlaying of virtual planning in terms of measures of the Computer Assisted Design/Computer Assisted Manufacturing CAD/CAM plate for mandibular reconstruction in patients who are ineligible for the insertion of reconstructing the titanium plate supported by fibular free flap, due to their poor health status, or in the presence of specific contraindications to autologous bone flap harvest. Materials and methods: The retrospective study performed analyzed the results of nine patients. The patients were treated at the Maxillofacial Surgery Unit of Policlinico S. Orsola of Bologna, Italy, and Policlinico San Marco, Catania, Italy, from April 2016 to June 2021. Superimposition between planning and post operative Computed Tomography CT scan was performed to assess the accuracy. Results: All reconstructive procedures were carried out successfully. No microsurgery-related complications occurred. In two cases, we had plate misplacement, and in one case, plate exposure that led to plate removal. The average accuracy of the series assessed after CT superimposition, as previously described, was 0.95 mm. Conclusions: Considering that microvascular bone transfer is a high-risk procedure in BRONJ patients, we can conclude that the positioning of a customized bridging mandibular prosthesis (CBMP), whether or not it is associated with a microvascular soft tissue transfer, is a safe technique in terms of surgical outcome and feasibility.

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Image-to-patient registration by natural anatomical surfaces of the head

Open Medicine ◽

10.2478/s11536-006-0042-7 ◽

2007 ◽

Vol 2 (1) ◽

pp. 89-102

Author(s):

Rüdiger Marmulla ◽

Joachim Mühling ◽

Georg Eggers

Keyword(s):

Maxillofacial Surgery ◽

Image Data ◽

Computer Assisted Surgery ◽

Laser Surface ◽

Oral And Maxillofacial Surgery ◽

Computer Assisted ◽

Ct Image ◽

Fiducial Markers ◽

Patient Registration ◽

Image Guided

AbstractThe use of registration markers in computer-assisted surgery is combined with high logistic costs and efforts.During the preparation of image guided surgery, automated markerless patient-to-image registration based on anatomical surfaces allows a significant reduction of preoperative effort and of the radiation dose the patient is exposed to. Placement and measurement of radio-opaque fiducial markers becomes unnecessary. The usability of face, auricle, maxilla and mandible for surface-based registration to CT image data was investigated. The present study was performed to evaluate the clinical accuracy in finding defined target points within the surgical site after markerless patient registration in image-guided oral and maxillofacial surgery.Preoperatively, the spatial position of 20 patients was registered to CT image data using a 3D laser surface scanner. Indications for surgery were tumours, foreign bodies and skeletal malformations. The accuracy of this surface-based registration was verified using additionally placed fiducial markers.The study showed, that markerless surface-based registration was sufficiently accurate for clinical use when the surface used for matching was the upper jaw, the face, or — with reservations — the auricle. Surface-based registration using the mandible did not yield satisfying results. To conclude, image-to-patient registration based on laser surface scanning is a valuable method for surgery of the head. Multiple sites of the head were identified as appropriate for the method. Hence, dependent on the individual case and the intended surgery, the registration area can be selected with the necessary flexibility.

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Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

Frontiers in Oncology ◽

10.3389/fonc.2021.719028 ◽

2021 ◽

Vol 11 ◽

Author(s):

Henriette L. Möllmann ◽

Laura Apeltrath ◽

Nadia Karnatz ◽

Max Wilkat ◽

Erik Riedel ◽

...

Keyword(s):

Computer Assisted Surgery ◽

Reference Points ◽

Mandibular Reconstruction ◽

Patient Specific ◽

Computer Assisted ◽

Advantages And Disadvantages ◽

Patient Specific Implants ◽

Operative Complications ◽

The Difference ◽

And Training

ObjectivesThis retrospective study compared two mandibular reconstruction procedures—conventional reconstruction plates (CR) and patient-specific implants (PSI)—and evaluated their accuracy of reconstruction and clinical outcome.MethodsOverall, 94 patients had undergone mandibular reconstruction with CR (n = 48) and PSI (n = 46). Six detectable and replicable anatomical reference points, identified via computer tomography, were used for defining the mandibular dimensions. The accuracy of reconstruction was assessed using pre- and postoperative differences.ResultsIn the CR group, the largest difference was at the lateral point of the condyle mandibulae (D2) -1.56 mm (SD = 3.8). In the PSI group, the largest difference between preoperative and postoperative measurement was shown at the processus coronoid (D5) with +1.86 mm (SD = 6.0). Significant differences within the groups in pre- and postoperative measurements were identified at the gonion (D6) [t(56) = -2.217; p = .031 <.05]. In the CR group, the difference was 1.5 (SD = 3.9) and in the PSI group -1.04 (SD = 4.9). CR did not demonstrate a higher risk of plate fractures and post-operative complications compared to PSI.ConclusionFor reconstructing mandibular defects, CR and PSI are eligible. In each case, the advantages and disadvantages of these approaches must be assessed. The functional and esthetic outcome of mandibular reconstruction significantly improves with the experience of the surgeon in conducting microvascular grafts and familiarity with computer-assisted surgery. Interoperator variability can be reduced, and training of younger surgeons involved in planning can be reaching better outcomes in the future.

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Computer-Assisted Oral and Maxillofacial Surgery

Maxillofacial Trauma and Esthetic Facial Reconstruction ◽

10.1016/b978-1-4377-2420-2.00032-5 ◽

2012 ◽

pp. 574-590 ◽

Cited By ~ 1

Author(s):

Stefan Hassfeld ◽

Joachim Mühling ◽

Marc C. Metzger ◽

Georg Eggers

Keyword(s):

Maxillofacial Surgery ◽

Oral And Maxillofacial Surgery ◽

Computer Assisted

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The provision of surgical tracheostomies by maxillofacial surgeons in the UK: time for a dedicated tracheostomy team?

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0173 ◽

2018 ◽

Vol 100 (2) ◽

pp. 116-119

Author(s):

P Chohan ◽

R Elledge ◽

MK Virdi ◽

GM Walton

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Telephone Survey ◽

Percutaneous Dilatational Tracheostomy ◽

Maxillofacial Surgery ◽

University Hospital ◽

Oral And Maxillofacial Surgery ◽

Surgical Tracheostomy ◽

Surgical Teams ◽

The Uk

Surgical tracheostomy is a commonly provided service by surgical teams for patients in intensive care where percutaneous dilatational tracheostomy is contraindicated. A number of factors may interfere with its provision on shared emergency operating lists, potentially prolonging the stay in intensive care. We undertook a two-part project to examine the factors that might delay provision of surgical tracheostomy in the intensive care unit. The first part was a prospective audit of practice within the University Hospital Coventry. This was followed by a telephone survey of oral and maxillofacial surgery units throughout the UK. In the intensive care unit at University Hospital Coventry, of 39 referrals, 21 (53.8%) were delayed beyond 24 hours. There was a mean (standard deviation) time to delay of 2.2 days (0.9 days) and the most common cause of delay was surgeon decision, accounting for 13 (61.9%) delays. From a telephone survey of 140 units nationwide, 40 (28.4%) were regularly involved in the provision of surgical tracheostomies for intensive care and 17 (42.5%) experienced delays beyond 24 hours, owing to a combination of theatre availability (76.5%) and surgeon availability (47.1%). There is case for having a dedicated tracheostomy team and provisional theatre slot to optimise patient outcomes and reduce delays. We aim to implement such a move within our unit and audit the outcomes prospectively following this change.

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