Computer-assisted navigation: its role in intraoperatively accurate mandibular reconstruction

Objective. This article presents our experiences of computer-assisted navigation in mandibular reconstruction and evaluates its effectiveness. Study Design. Eight patients who underwent navigation-guided mandibular reconstruction with a fibula free flap were reviewed. Under intraoperative navigation, the ideal positions of the mandibular angles and condyles were confirmed by the navigation probe. The surgical results were evaluated through postoperative panoramic radiographs, coronal computed tomography scans, and image fusion. Results. Navigation-guided mandibular reconstructions were successfully completed on the basis of preoperative planning and simulation. The surgical discrepancy in the mandibular angle between the actual surgical results and the preoperative designs was 1.92 +/- 0.97 mm. Panoramic radiographs and coronal computed tomography scans illustrated that all the condyles fitted into their glenoid fossae. All patients were satisfied with their functional and aesthetic outcomes. Conclusions. Computer-assisted navigation is a viable technology for improving surgical outcomes in mandibular reconstruction, which can assist the surgeons by providing real-time three-dimensional surgical references during the operation.