Surgical navigation in cranio-maxillofacial surgery

Introduction Surgical navigation is well-established in today’s cranio-maxillofacial surgery. However, it is often associated with extra effort for both patient and surgeon and with additional exposure to radiation due to necessary extra imaging. The cranio-orbitofacial structures are challenging with respect to accurate three-dimensional (3D) reconstruction. A virtual plan based on mirrored patient anatomy and intraoperative navigation can assist in achieving perfect results. However, in several cases, navigation is not useful. Therefore, the aim of the current study was to evaluate the indications for surgical navigation with the help of various examples. Method Surgeries of the Clinic for Cranio-Maxillofacial Surgery at the University Hospital Zurich between 2003 and 2009 in which surgical navigation was performed or preoperatively discussed were evaluated for typical patterns. Some examples of those cases are presented in regard to evaluation of the spectrum of indications. Conclusion Especially in situations dealing with complex 3D-anatomy, surgical navigation based on a virtual plan can be a great benefit in achieving symmetrical results. Surgical navigation does not necessarily mean additional procedures or imaging. Overall, we believe that virtual planning and surgical navigation is a useful tool for selected cases.