Computer-assisted, Le Fort-based, face–jaw–teeth transplantation: a pilot study on system feasiblity and translational assessment

Ryan J. Murphy, Chad R. Gordon, Ehsan Basafa, Peter Liacouras, Gerald T. Grant, Mehran Armand

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Le Fort-based face–jaw–teeth transplantation (FJTT) attempts to marry bone and teeth geometry of size-mismatched face–jaw–teeth segments to restore function and form due to severe mid-facial trauma. Recent development of a computer-assisted planning and execution (CAPE) system for Le Fort-based FJTT in a pre-clinical swine model offers preoperative planning, and intraoperative navigation. This paper addresses the translation of the CAPE system to human anatomy and presents accuracy results. Methods: Single-jaw, Le Fort-based FJTTs were performed on plastic models, one swine and one human, and on a human cadaver. Preoperative planning defined the goal placement of the donor’s Le Fort-based FJTT segment on the recipient. Patient-specific navigated cutting guides helped achieve planned osteotomies. Intraoperative cutting guide and donor fragment placement were compared with postoperative computed tomography (CT) data and the preoperative plan. Results: Intraoperative measurement error with respect to postoperative CT was less than 1.25 mm for both mock transplants and 3.59 mm for the human cadaver scenario. Donor fragment placement (as compared to the planned position) was less accurate for the human model test case (2.91 mm) compared with the swine test (2.25 mm) and human cadaver (2.26 mm). Conclusion: The results indicate the viability of the CAPE system for assisting with Le Fort-based FJTT and demonstrate the potential in human surgery. This system offers a new path forward to achieving improved outcomes in Le Fort-based FJTT and can be modified to assist with a variety of other surgeries involving the head, neck, face, jaws and teeth.

Original languageEnglish (US)
Pages (from-to)1117-1126
Number of pages10
JournalInternational Journal of Computer Assisted Radiology and Surgery
Volume10
Issue number7
DOIs
StatePublished - Jul 3 2015

Keywords

  • Face transplant
  • Face–jaw–teeth transplantation
  • Le Fort-based transplant
  • Navigation
  • Preoperative planning
  • Surgical cutting guide

ASJC Scopus subject areas

  • Surgery
  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging
  • Computer Vision and Pattern Recognition
  • Health Informatics
  • Computer Science Applications
  • Computer Graphics and Computer-Aided Design

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