Virtual Surgical Planning and Pre-operative Simulation for Maxillofacial Reconstruction with 3D Printing Technology in Tumor-affected Facial Deformity

Author(s): Gyeong-Man Kim, Masreshaw Demelash Bayleyegn, Song-Jung Kim

Background: The high anatomical complexity of maxillofacial defects caused by tumor can pose a formidable challenge for clinicians when designing an appropriate plan for surgical reconstruction. The intention of this work was to restore the complex anatomy with maximum possible facial functionality and aesthetics of the patient. Based on the medical images generated by Computed Tomography (CT) scan an optimal therapeutic planning for complex maxillofacial reconstruction was designed.

Method: Firstly, the volumetric data sets were carefully evaluated and deeply inspected for accurate diagnosis. Regarding 3D visualization of the CT scan images 3D virtual models for regions of interest were created using special software of 3D Slicer. Using the resulting 3D virtual models a well-defined virtual surgical planning was generated for multiple surgical procedures, including the osteotomies for bone defects, harvesting autogenous bone graft and creating a customized implant.

Results: The relevant patient-specific anatomical models for real surgery were translated into the 3D printed physical models, with which the surgeons can rehearse the surgery before coming into the operating room. Precisely defined multiple surgeries for complex maxillofacial reconstruction were proposed in this research that could be transferred to the real-time surgery.

Conclusions: The proposed surgical approach will be beneficial both for the surgeons and patient, including improvement in surgical precision and outcomes, reduction in operating time, as well as understanding surgical procedures and decision making etc. In addition, it is worth noting that such an appropriate methodology with free, open source software is highly adaptable in medical education, especially for lowresource countries.