West China Journal of Stomatology ›› 2022, Vol. 40 ›› Issue (6): 676-684.doi: 10.7518/hxkq.2022.06.008

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Application of mixed reality-based surgical navigation system in craniomaxillofacial trauma bone reconstruction

Lin Chengzhong1(), Zhang Yong2, Dong Shao3, Wu Jinyang2, Zhang Chuxi2, Wan Xinjun3, Zhang Shilei2()   

  1. 1.The 2nd Dental Center, Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine; College of Stomatology, Shanghai JiaoTong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
    2.Dept. of Oral and Cranio-Maxillofacial Surgery, Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine; College of Stomatology, Shanghai JiaoTong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
    3.School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, Shanghai 200011, China
  • Received:2022-06-26 Revised:2022-10-25 Online:2022-12-01 Published:2022-11-23
  • Contact: Zhang Shilei E-mail:Evan-lin@sjtu.edu.cn;leinnymd@hotmail.com
  • Supported by:
    Science and Technology Suppont Project of Shanghai Science and Technology Committee(20S31902200);Correspondence: Zhang Shilei, E-mail: leinnymd@hotmail.com

Abstract:

Objective This study aimed to build a surgical navigation system based on mixed reality (MR) and optical positioning technique and evaluate its clinical applicability in craniomaxillofacial trauma bone reconstruction. Me-thods We first integrated the software and hardware platforms of the MR-based surgical navigation system and explored the system workflow. The systematic error, target registration error, and osteotomy application error of the system were then analyzed via 3D printed skull model experiment. The feasibility of the MR-based surgical navigation system in craniomaxillofacial trauma bone reconstruction was verified via zygomatico-maxillary complex (ZMC) reduction experiment of the skull model and preliminary clinical study. Results The system error of this MR-based surgical navigation system was 1.23 mm±0.52 mm, the target registration error was 2.83 mm±1.18 mm, and the osteotomy application error was 3.13 mm±1.66 mm. Virtual surgical planning and the reduction of the ZMC model were successfully conducted. In addition, with the guidance of the MR-based navigation system, the frontal bone defect was successfully reconstructed, and the clinical outcome was satisfactory. Conclusion The MR-based surgical navigation system has its advantages in virtual reality fusion effect and dynamic navigation stability. It provides a new method for doctor-patient communications, education, preoperative planning, and intraoperative navigation in craniomaxillofacial surgery.

Key words: craniomaxillofacial surgery, mixed reality, surgical navigation, virtual surgery, reconstruction

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