Navigation-guided resection of maxillary tumors: Can a new volumetric virtual planning method improve outcomes in terms of control of resection margins?

Introduction: In the present study, our aim was to confirm the role of navigation-guided surgery in reducing the percentage of positive margins in advanced malignant pathologies of the mid-face, by introducing a new volumetric virtual planning method for resection. Materials and methods: Twenty-eight patients were included in this study. Eighteen patients requiring surgery to treat malignant midface tumors were prospectively selected and stratified into two different study groups. Patients enrolled in the Reference Points Resection group (RPR - 10 patients) underwent resection planning using the anatomical landmarks on CT scan; patients enrolled in the Volume Resection group (VR - 8 patients) underwent resection using the new volumetric virtual planning method. The remaining 10 patients (Control group) were treated without the use of a navigation system. Results: In total, 127 margins were pathologically assessed in the RPR group, 75 in the VR group, and 85 in the control group. In the control group, 16% of the margins were positive, while in the RPR group the value was 9%, and in the VR group 1%. Conclusions: The volumetric tumor resection planning associated to the navigation-guide resection appeared to be an improvement in terms of control of surgical margins in advanced tumors involving the mid-face. (C) 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.