The surgical segment navigator (SSN) is a computer-based system for use in surgical navigation. It is integrated into a common platform, together with the surgical tool navigator (STN), the surgical microscope navigator (SMN) and the 6DOF manipulator (MKM), developed by Carl Zeiss.
The SSN has been developed as a computer system for bone segment navigation in oral and maxillofacial surgery. [1] It allows a very precise repositioning of bone fragments, with the advent of preoperative simulation and surgical planning. [2] The system has been developed since 1997 at the University of Regensburg, Germany, with the support of the Carl Zeiss Company. Its principle is based on an infrared localisation system, composed of an infrared camera and at least three infrared transmitters attached to each bony fragment. The SSN is mainly used in orthognatic surgery (surgical correction of dysgnathia), but also for the surgical reconstruction of the orbit, or other surgical interventions to the midface.
Since 2001, at the University of Heidelberg, Germany, the SSN++ has been developed, a markerless-registration navigation system, based on a native (=markerless) CT or MRI. In this case, the patient registration is obtained on the operating table, using a surface scanner. [3] The SSN++ correlates the surface scan data (gathered on the operating table) with the skin surface reconstruction from the dataset obtained preoperatively by CT or MRI. This principle complies with the terrain contour matching principle described for flying objects. The advantage of the new method is that the registration of the patient's position becomes a simple automated procedure; on the other hand, the radiation load for the patient is reduced, compared to the method using markers. [4] [5]
Oral and maxillofacial surgery is a surgical specialty focusing on reconstructive surgery of the face, facial trauma surgery, the oral cavity, head and neck, mouth, and jaws, as well as facial cosmetic surgery/facial plastic surgery including cleft lip and cleft palate surgery.
Microsurgery is a general term for surgery requiring an operating microscope. The most obvious developments have been procedures developed to allow anastomosis of successively smaller blood vessels and nerves which have allowed transfer of tissue from one part of the body to another and re-attachment of severed parts. Microsurgical techniques are utilized by several specialties today, such as general surgery, ophthalmology, orthopedic surgery, gynecological surgery, otolaryngology, neurosurgery, oral and maxillofacial surgery, endodontic microsurgery, plastic surgery, podiatric surgery and pediatric surgery.
Chin augmentation using surgical implants alter the underlying structure of the face, intended to balance the facial features. The specific medical terms mentoplasty and genioplasty are used to refer to the reduction and addition of material to a patient's chin. This can take the form of chin height reduction or chin rounding by osteotomy, or chin augmentation using implants. Altering the facial balance is commonly performed by modifying the chin using an implant inserted through the mouth. The intent is to provide a suitable projection of the chin as well as the correct height of the chin which is in balance with the other facial features.
Orthognathic surgery, also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion problems primarily arising from skeletal disharmonies, and other orthodontic dental bite problems that cannot be treated easily with braces, as well as the broad range of facial imbalances, disharmonies, asymmetries, and malproportions where correction may be considered to improve facial aesthetics and self-esteem.
Laser surgery is a type of surgery that uses a laser to cut tissue.
Osteonecrosis of the jaw (ONJ) is a severe bone disease (osteonecrosis) that affects the jaws. Various forms of ONJ have been described since 1861, and a number of causes have been suggested in the literature.
Neuronavigation is the set of computer-assisted technologies used by neurosurgeons to guide or "navigate" within the confines of the skull or vertebral column during surgery, and used by psychiatrists to accurately target rTMS. The set of hardware for these purposes is referred to as a neuronavigator.
The Le Fortfractures are a pattern of midface fractures originally described by the French surgeon, René Le Fort, in the early 1900s. He described three distinct fracture patterns. Although not always applicable to modern-day facial fractures, the Le Fort type fracture classification is still utilized today by medical providers to aid in describing facial trauma for communication, documentation, and surgical planning. Several surgical techniques have been established for facial reconstruction following Le Fort fractures, including maxillomandibular fixation (MMF) and open reduction and internal fixation (ORIF). The main goal of any surgical intervention is to re-establish occlusion, or the alignment of upper and lower teeth, to ensure the patient is able to eat. Complications following Le Fort fractures rely on the anatomical structures affected by the inciding injury.
Patient registration is used to correlate the reference position of a virtual 3D dataset gathered by computer medical imaging with the reference position of the patient. This procedure is crucial in computer assisted surgery, in order to insure the reproducitibility of the preoperative registration and the clinical situation during surgery. The use of the term "patient registration" out of this context can lead to a confusion with the procedure of registering a patient into the files of a medical institution.
Bone segment navigation is a surgical method used to find the anatomical position of displaced bone fragments in fractures, or to position surgically created fragments in craniofacial surgery. Such fragments are later fixed in position by osteosynthesis. It has been developed for use in craniofacial and oral and maxillofacial surgery.
Computer-assisted surgery (CAS) represents a surgical concept and set of methods, that use computer technology for surgical planning, and for guiding or performing surgical interventions. CAS is also known as computer-aided surgery, computer-assisted intervention, image-guided surgery, digital surgery and surgical navigation, but these are terms that are more or less synonymous with CAS. CAS has been a leading factor in the development of robotic surgery.
Surgical planning is the preoperative method of pre-visualising a surgical intervention, in order to predefine the surgical steps and furthermore the bone segment navigation in the context of computer-assisted surgery. The surgical planning is most important in neurosurgery and oral and maxillofacial surgery. The transfer of the surgical planning to the patient is generally made using a medical navigation system.
Laboratory Unit for Computer Assisted Surgery is a system used for virtual surgical planning. Starting with 1998, LUCAS was developed at the University of Regensburg, Germany, with the support of the Carl Zeiss Company. The resulting surgical planning is then reproduced onto the patient by using a navigation system. In fact, LUCAS is integrated into the same platform together with the Surgical Segment Navigator (SSN), the Surgical Tool Navigator (STN), the Surgical Microscope Navigator (SMN) and the 6DOF Manipulator, also from the Carl Zeiss Company.
Neuralgia-inducing cavitational osteonecrosis (NICO) is a diagnosis whereby a putative jawbone cavitation causes chronic facial neuralgia; this is different from osteonecrosis of the jaw. In NICO the pain is said to result from the degenerating nerve ("neuralagia"). The condition is probably rare, if it does exist.
The Dextroscope is a medical equipment system that creates a virtual reality (VR) environment in which surgeons can plan neurosurgical and other surgical procedures.
Rüdiger Marmulla is a German cranio-maxillofacial surgeon.
Frank Hölzle is a German surgeon. He is a professor of oral and maxillofacial surgery at the RWTH Aachen University. He is chairman and head of the Department of Oral and Maxillofacial Surgery. Hölzle is known for his work in the fields of plastic facial reconstruction with a focus on micro surgery. He is also specialised for the treatment of tumor diseases in the head and neck region, and of malformations like cleft lip and palate.
Alveoloplasty is a surgical pre-prosthetic procedure performed to facilitate removal of teeth, and smoothen or reshape the jawbone for prosthetic and cosmetic purposes. In this procedure, the bony edges of the alveolar ridge and its surrounding structures is made smooth, redesigned or recontoured so that a well-fitting, comfortable, and esthetic prosthesis may be fabricated or implants may be surgically inserted. This pre-prosthetic surgery which may include bone grafting prepares the mouth to receive a prosthesis or implants by improving the condition and quality of the supporting structures so they can provide support, better retention and stability to the prosthesis.
It is estimated that nearly 30% of the general population present with malocclusions that are in great need of orthodontic treatment. However, the term dentofacial deformity describes an array of dental and maxillo-mandibular abnormalities, often presenting with a malocclusion, which is not amenable to orthodontic treatment alone and definitive treatment needs surgical alignment of upper/lower jaws or both. Individuals with dentofacial deformities often present with lower quality of life and compromised functions with respect to breathing, swallowing, chewing, speech articulation, and lip closure/posture. It is estimated that about 5% of general population present with dentofacial deformities that are not amenable to orthodontic treatment only.
Mandibular setback surgery is a surgical procedure performed along the occlusal plane to prevent bite opening on the anterior or posterior teeth and retract the lower jaw for both functional and aesthetic effects in patients with mandibular prognathism. It is an orthodontic surgery that is a form of reconstructive plastic surgery. There are three main types of procedures for mandibular setback surgery: Bilateral Sagittal Split Osteotomy (BSSO), Intraoral Vertical Ramus Osteotomy (IVRO) and Extraoral Ramus Osteotomy (EVRO), depending on the magnitude of mandibular setback for each patient. Postoperative care aims to minimise postoperative complications, complications includes bite changes, relapse and nerve injury.