A novel computer-assisted surgical planning and intra-operative navigation system for use in complex craniomaxillofacial (CMF) surgical procedures such as Le Fort-based, maxillofacial transplantation.
Le Fort-based, maxillofacial transplantation accompanying a single jaw with teeth is an emerging therapeutic option for patients presenting with complex CMF deformities, resulting from etiologies such as gunshot wounds, burns and trauma. To date, eight patients have undergone single jaw maxillofacial transplantation around the world, and unfortunately, all have developed post-operative deformities due to size-mismatch and malocclusion requiring major corrective surgery. With this in mind, a translational large animal study was conducted to solve this problem and develop a computer-assisted technology platform that could, for the first time, supply the surgeon with a single system encompassing both patient-specific pre-operative planning capabilities AND intra-operative navigational guidance. Preliminary data shows this technology to be successful in optimizing post-operative facial skeletal deformities for all size-mismatch scenarios (in both swine and human transplants). Additional advantages of this technology include:
• Improved cutting accuracy and donor-recipient interface alignment/guide placement verification
• Precise navigational accuracy (down to the millimeter)
• Real-time surgical feedback
• Reduces surgery operation time, blood loss, and morbidity
Johns Hopkins researchers and collaborators have developed a computer-assisted solution customized for pre-operative planning, intra-operative navigation, and real-time cephalometric feedback - as needed for facial transplantation and similar craniofacial/orthognathic procedures. Before surgery, the workstation creates 3D models of donor/recipient CT scans and uses cephalometric analyses to predict combined facial skeleton appearance/occlusion. Patient-specific, snap-on cutting guides and palatal splints are digitally designed/manufactured to improve surgical accuracy and transplant alignment, in addition to reducing total operative times. In the O.R., this system tracks surgical instruments and custom cutting guides with respect to donor/recipient anatomical features; and continuous cephalometric analyses provides unprecedented feedback to the surgeon.
Looking for Partners
To develop and commercialize the technology as a tool to improve all types of craniomaxillofacial surgical procedures including Le Fort-based, maxillofacial transplantation.
Stage of Development
Chad Gordon, Mehran Armand, Gerald Grant, Peter Liacouras, Ryan Murphy
1. Ann Plast Surg. 2013 Oct;71(4):421-8;
2. Plast Reconstr Surg. 2014 May;133(5):1138-51;
3. J Craniofac Surg. 2014 Jan;25(1):273-83;
4. Ann Plast Surg. 2014 Jun;72(6):720-4;
5. J Biomech. 2014 Jun 6. pii: S0021-9290(14)00330-3
Craniofacial surgery, Orthognathic surgery, Occlusion, Cephalometric analysis, Transplant, Le Fort, Maxillofacial, Surgical