Surgical Navigation Improves Planning and Precision

Dentistry Today


Surgical navigation promises to improve oral and maxillofacial surgery, tough its high cost and steep learning curve are possible drawbacks, report researchers from Odense University Hospital in Denmark and the Providence Cancer Center in Providence, Ore. It can be particularly useful in surgical planning, execution, evaluation, and research, according to the study.

Using a system to track instruments during computer-assisted surgery, surgical navigation is similar to the use of GPS in cars. Through its 3 chief components—a localizer similar to a satellite, a surgical probe, and a computed tomography scan dataset similar to a map—data is input into a computer and used to guide surgical procedures. 

The researchers examined surgical navigation’s most common indications, treatments, and outcomes via databases, journals, and bibliographies published between 2010 and 2015 that included clinical studies of at least 5 patients. Subjects included traumatology, orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign body removal. 

The use of surgical navigation considerably improved the treatment of complex orbital fractures compared to traditionally treated control groups, the researchers concluded. They also said that it is an excellent device for treatment evaluation and could have a role in research in the pursuit of clinical excellence.

In orthognathic surgery, surgical navigation lets the operator relate segment movements to the simulated plan for cutting bone, which is otherwise impossible with traditional model surgical procedures that carry a higher risk of inaccuracy. Also, planning a procedure in a 3-D environment and executing it with real-time guidance can greatly improve precision, though all surgical team members have to be highly integrated into the process, the researchers said. 

While surgical navigation has been tried in maxillofacial surgery, some major challenges have occurred, the researchers noted. Great surgical skills cannot be compromised when considering integrating surgical navigation into the treatment regiment, they reported. The researchers concluded that potential issues include the learning curve and financial concerns, although oral and maxillofacial surgeons have called it very beneficial when the techniques have been adequately mastered. 

The study, “Surgical Navigation: A Systematic Review of Indications, Treatments, and Outcomes in Oral and Maxillofacial Surgery,” was published by The Journal of Oral and Maxillofacial Surgery.

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