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Preoperative planning and intraoperative navigation in the reconstructive craniofacial surgery

Król Z., Chapuis J., Schwenzer-Zimmerer K., Langlotz F., Zeilhofer H.-F.

Journal of Medical Informatics & Technologies

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2005

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Vol. 9

83--89

EN

We present a methodology for navigation-aided surgical treatments in the reconstructive craniofacial surgery. Using the case of zygomatic bone repositioning after gunshot wound trauma the whole preoperative planning process and the intra-operative navigation oriented issues are explicitly described. We have focused our attention on the new navigation oriented aspects and procedures which facilitate and enhance the traditional treatment techniques. Many illustrations let better understand the complex technical dependencies between the main elements of this approach. The presented procedures permit more precise planning and performing of the surgical treatment, reducing intra-operative time and improving the post-operative outcome.

2

Modeling of X-ray propagation in bone microstructure

Binkowski M., Król Z., Wróbel Z., Zeilhofer H.-F.

Journal of Medical Informatics & Technologies

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2005

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Vol. 9

75--82

EN

This paper presents some results concerning the analysis of X-ray propagation through biological structures. We introduce a physical model of the phenomenon and a numerical method based on this model for simulation of X-ray radiation propagation. The proposed method enables generation of radiological projections like those in the computed tomography or microtomography. We have focused our attention on the attenuation of X-ray radiation in bone tissue. Our computational model enables simulation of radiation propagation in the virtual specimen. The virtual bone microstructures used in our experiments are derived from the microtomography datasets of real bone specimens. The main advantage of our approach is that we can change the microstructure of the virtual sample in many ways by using the image processing methods. Results presented in this paper contain simulations of X-ray propagation for modified and unmodified trabecular microstructures as well as the visualization of the radiation intensity distribution for the simulated cases. With this new simulation technique, it is possible for example to analyze the propagation of X-ray radiation for different pathologic types of bone microstructure (e.g. virtually generated osteoporosis).

3

Patient-specific graft design method for cranofacial surgical planning

Król Z., Chlebiej M., Zerfass P., Zeilhofer H.-F., Sader R., Mikołajczak P., Keeve E.

Journal of Medical Informatics & Technologies

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2002

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Vol. 3

MI189--197

EN

This paper presents a method for computer assisted selection of optimal donor sites for autologous osseous grafts in the craniofacial surgery. At the initial graft design stage the surgeon defines in the CT data set the shape of the bone segment to be reconstructed and in the donor region CT data set a set of constraints for the optimization task. This non-automatic step is followed by a fully automatic optimization stage, which delivers a set of sub-optimal and optimal donor sites for a given template. Such approach permits the surgeon to find the best site for harvesting the graft and enables an exact anatomical reconstruction of the osseous section.

4

An automated osteotomy design for autologous bone grafts in craniofacial surgery

Król Z., Zerfass P., Sader R., Zeilhofer H.-F., Keeve E.

Journal of Medical Informatics & Technologies

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2001

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Vol. 2, Part. 2

MT117--MT124

EN

In the treatment of craniofacial osseous defects it is frequently required that the surgeon has to graft bone to replace a missing or surgically removed segment. The reconstruction of this area poses a difficult challenge owing to the complexity of its bony structures as well as to its great importance for the chewing and speech ability. A common method of surgically reconstructing the craniofacial region involves using autologous grafts. By using the registration framework a novel surgery planning method has been developed. The method enables computer-aided selection of optimal donor sites for autologous bone grafts in the craniofacial surgery. The main advantage of the method is that after determination of the initial conditions and constraints it provides an automatic procedure to find the best fitting position. All generated solutions can be explored interactively on the computer display via an efficient graphical interface. Applying different similarity measures enables the surgeon to select the optimal donor site not only in terms of bone surface correlation but also according to the whole volumetric information contained in both data sets. This new approach permits more precise planning of the surgical procedure, reducing intraoperative time and improving the postoperative outcome.