Document Detail


Computer-assisted navigational surgery improves outcomes in orbital reconstructive surgery.
MedLine Citation:
PMID:  22976663     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
ABSTRACT: Orbital reconstruction is a difficult procedure, success of which is dependent on the surgeon's experience. The lack of objective methods requires a fair amount of estimation is its execution. This study evaluates the efficacy of Kolibri (BrainLab, Munich, Germany), an intraoperative navigation device, in improving outcomes.From 2004 to 2009, 58 patients with orbital trauma who underwent surgery at the National University Hospital, Singapore, were included in this prospective matched control trial. Twenty-nine consecutive patients underwent surgery with Kolibri. The control group underwent surgery without the device. Both groups were matched for age, sex, orbital wall fracture, preoperative ophthalmologic features, etiology and severity of trauma, surgical approach, and types of implant used. The postoperative follow-up was at 1, 3, 6, and 12 months. For subjective assessment, the postoperative ophthalmologic features, including diplopia, infraorbital hypoesthesia, ophthalmoplegia, and enophthalmos, were compared. At 1, 3, 6, and 12 months, respectively, there were fewer patients with postoperative ophthalmologic complications in the study group (italicized; n = 29) compared with the control group (n = 29; P < 0.05): 12/29 (41%) versus 21/29 (72%), 8/29 (28%) versus 19/29 (66%), 5/29 (17%) versus 15/29 (52%), and 2/29 (7%) versus 12/29 (41%).For objective assessment, using the Kolibri workstation, operative plans were created and fused with postoperative computed tomographic scans. Vertical distances between the actual reconstructed and planned orbital floors were measured. On average, the vertical distance measured from the boundaries of floor defects for patients in the study group was 3.24 mm (95% confidence interval, 1.56-4.91) lower than the control group (P = 0.001).In conclusion, navigation minimizes postoperative complications, reduces the need for repeat procedures, and helps surgeons with planning, execution, and postoperative assessment.
Authors:
Elijah Zhengyang Cai; Yun Pei Koh; Eileen Chor Hoong Hing; Jin Rong Low; Jia Yi Shen; Hung Chew Wong; Gangadhara Sundar; Thiam Chye Lim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of craniofacial surgery     Volume:  23     ISSN:  1536-3732     ISO Abbreviation:  J Craniofac Surg     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010410     Medline TA:  J Craniofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1567-73     Citation Subset:  D    
Affiliation:
From the *Yong Loo Lin School of Medicine, National University of Singapore, Singapore; †Department of Surgery, National University Health System, Singapore; ‡Biostatistics Unit, National University of Singapore, Singapore; §Department of Ophthalmology, National University Health System, Singapore; and ∥Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore.
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