Application of 3D Simulation Surgery to Orthognathic Surgery of Hemimandibular Hypoplasia

Park, Jin Hoo,Jung, Young-Soo,Kwon, Sun-Mo,Lim, Jae-Seok,Jung, Hwi-Dong International Society for Simulation Surgery 2016 Journal of International Society for Simulation Su Vol.3 No.2

Traditionally 2D cephalometric analysis has been used for diagnosis and treatment of maxillofacial deformities. However, 2D has some limitations in diagnosis and treatment planning especially facial asymmetry cases. The most weakness of 2D is overlapping and unpredictability. Today 3D treatment tools are used by many maxillofacial surgeons. 3D treatment tools can show ungarbled facial anatomy and do virtual surgery. The aim of this report is to present usefulness of using 3D analysis and virtual orthognathic surgery for severe facial asymmetry patients.

The Reliability of Preoperative Simulation Surgery Planning for Distraction Osteogensis in Craniosynostosis Patients

Hussein, Mohammed Ahmed,Kim, Yong Oock International Society for Simulation Surgery 2016 Journal of International Society for Simulation Su Vol.3 No.1

Background Craniosynostosis management using distraction osteogensis represent a challenge for surgeons due to the great variability of the skull deformity even within the same etiology. The ability to apply the simulation surgery for improving the preoperative planning for distraction osteogensis could improve the results.Planning and Simulation 14 patients presented with craniosynostosis had been subjected to simulation surgery prior to real surgery. 3D CT scans was obtained upon patient admission. Adjustment of all skull position to Frankfort horizontal plane was done. 3 different distraction osteogensis plans were done for each patient according to the skull morphology. For each plane, movement for each bone segment was done according to the pre-planned distraction vectors. Also the distances of distractions were pre-determined according to the cephalic index as well as brain volume. Intraoperatively, we choose the most appropriate plan for the patient by the surgeon. At the end of distraction, 3D CT scan was obtained, and was compared to the simulation plan. Also the distance and the direction of distraction was compared to that of the plan. Accordingly, the distance was almost matching that of the simulation surgery, however the vector of distraction was not matched.Conclusion Preoperative stimulation planning for craniosynostosis patient is very valuable tool in the surgical management of craniosynostosis patients.

Virtual Reality and 3D Printing for Craniopagus Surgery

Kim, Gayoung,Shim, Eungjune,Mohammed, Hussein,Kim, Youngjun,Kim, Yong Oock International Society for Simulation Surgery 2017 Journal of International Society for Simulation Su Vol.4 No.1

Purpose Surgery for separating craniopagus twins involves many critical issues owing to complex anatomical features. We demonstrate a 3D printed model and virtual reality (VR) technologies that could provide valuable benefits for surgical planning and simulation, which would improve the visualization and perception during craniopagus surgery. Material & Methods We printed a 3D model extracted from CT images of craniopagus patients using segmentation software developed in-house. Then, we imported the 3D model to create the VR environment using 3D simulation software (Unity, Unity Technologies, CA). We utilized the HTC Vive (HTC & Valve Corp) head-mount-display for the VR simulation. Results We obtained the 3D printed model of craniopagus patients and imported the model to a VR environment. Manipulating the model in VR was possible, and the 3D model in the VR environment enhanced the application of user-friendly 3D modeling in surgery for craniopagus twins. Conclusion The use of the 3D printed model and VR has helped understand complicated anatomical structures of craniopagus patients and has made communicating with other medical surgeons in the field much easier. Further, interacting with the 3D model is possible in VR, which enhances the understanding of the craniopagus surgery as well as the success rate of separation surgery while providing useful information on diagnosing and surgery planning.

Accuracy of Maxillary Segmental Osteotomy using 3D Simulation: A Case Report

Lee, Yong Bin,Yeo, Gisung,Jung, Young-Soo,Jung, Hwi-Dong International Society for Simulation Surgery 2015 Journal of International Society for Simulation Su Vol.2 No.2

To overcome limitations of conventional diagnosis and planning for orthognathic surgery, surgeons have begun to use 3-dimensional (3D) virtual simulation to plan complex orthognathic surgery. In many literatures, it has shown that better surgical outcome achieved with 3D virtual simulation than that with conventional methods. But, there is still lack of data about accuracy of maxillary segmental surgery with 3D virtual simulation. The purpose of this paper was to report the case of maxillary segmental orthognathic surgery with 3D virtual simulation and to assess the actual surgical outcome. Though the result was clinically acceptable, discrepancy between 3D simulation and actual surgery was not superior compared with conventional method. The accuracy of 3D simulation surgery and intermediate wafer fabrication for maxillary segmental surgery needs to be improved. Advancement in 3D software program and careful surgical technique will make it more precise and reliable method.

Mandibular Reconstruction using Simulation Surgery after Segmental Mandibulectomy

Hwang, Jong-Hyun,Kim, Ji-Wan,Ahn, Kang-Min International Society for Simulation Surgery 2016 Journal of International Society for Simulation Su Vol.3 No.1

Functional and esthetic reconstruction after segmental mandibulectomy is one of the most challenging surgeries in microsurgical reconstruction field. Simulation surgery before free flap reconstruction has been performed for efficient surgery and successful results. Fibula free flap is the flap of the choice for reconstruction of the segmental mandibular defect. Straight nature of the fibula bone requires multiple segmentations to fit into mandible. 3D rapid prototype (RP) model gives a lot of information for mandibular reconstruction. The purpose of this study was to report mandibular reconstruction with free fibular flap using simulation surgery. A total of 30 consecutive patients were included for functional and esthetic evaluation. Among 30 patients, two flaps showed necrosis after radiotherapy. The other flaps were all survived and showed successful reconstruction in both function and esthetics.

Maxillary Positioning Device for Intermediate Waferless Orthognathic Surgery

Lee, Jung-woo International Society for Simulation Surgery 2016 Journal of International Society for Simulation Su Vol.3 No.2

Le fort 1 osteotomy surgery is one of the most popular surgical methods for the treatment of patients with facial bone deformities. An intermediate wafer splint is used to fix the bone segment to the planned position, but there are many steps that can cause errors. To reduce these errors, we propose a method of using a surgical guide made with virtual surgical simulation.

Use of 3D Printing Model for the Management of Fibrous Dysplasia: Preliminary Case Study

Choi, Jong-Woo,Jeong, Woo Shik International Society for Simulation Surgery 2016 Journal of International Society for Simulation Su Vol.3 No.1

Fibrous dysplasia is a relatively rare disease but the management would be quite challenging. Because this is not a malignant tumor, the preservation of the facial contour and the various functions seems to be important in treatment planning. Until now the facial bone reconstruction with autogenous bone would be the standard. Although the autogenous bone would be the ideal one for facial bone reconstruction, donor site morbidity would be the inevitable problem in many cases. Meanwhile, various types of allogenic and alloplastic materials have been also used. However, facial bone reconstruction with many alloplastic material have produced no less complications including infection, exposure, and delayed wound healing. Because the 3D printing technique evolved so fast that 3D printed titanium implant were possible recently. The aim of this trial is to try to restore the original maxillary anatomy as possible using the 3D printing model, based on the mirrored three dimensional CT images based on the computer simulation. Preoperative computed tomography (CT) data were processed for the patient and a rapid prototyping (RP) model was produced. At the same time, the uninjured side was mirrored and superimposed onto the traumatized side, to create a mirror-image of the RP model. And we molded Titanium mesh to reconstruct three-dimensional maxillary structure during the operation. This prefabricated Titanium-mesh implant was then inserted onto the defected maxilla and fixed. Three dimensional printing technique of titanium material based on the computer simulation turned out to be successful in this patient. Individualized approach for each patient could be an ideal way to restore the facial bone.

3D Face Modeling using Face Image

Kim, Sanghyuk,Ban, Yuseok,Park, Changhyun,Lee, Sangyoun International Society for Simulation Surgery 2015 Journal of International Society for Simulation Su Vol.2 No.1

Purpose It has been stated that patient satisfaction is the crucial factor for determining success in plastic surgery. The convergence of medical science and computer vision has made easier to satisfy patients who wants to have plastic surgery. In this paper, we try to apply 3D face modeling in plastic surgical area. Materials and Methods The author introduces a method for accurate 3D face modeling techniques using a statistical model-based 3D face modeling approach in a mirror system. Results We could successfully obtain highly accurate 3D face shape results. Conclusion The method suggested could be used for acquiring 3D face models from 2D face image and the result obtained from this could be effectively used for plastic surgical areas.

Mandibular Reconstruction using Simulation Surgery with 3D RP Model in Osteoradionecrosis Patient: A Case Report

Park, Tae-Jun,Kim, Hong-Joon,Ahn, Kang-Min International Society for Simulation Surgery 2015 Journal of International Society for Simulation Su Vol.2 No.2

One of the most serious complications after head and neck radiation is osteoradionecrosis (ORN) of the jaw. The etiology of ORN is extraction, minor dental procedure or dental implant surgery. When ORN of the jaw progressed to stage III, free fibular flap is the most useful methods for reconstruction. In this case report, a 67-year-old ORN patient who underwent fibular free flap reconstruction using simulation surgery with 3-dimensional rapid prototype (3D RP) model was reviewed. After partial mandibulectomy, a osteocutaneous fibula flap was used for reconstruction. Oro-cutaneous fistula was resolved after operation. Patients reported improved food intake after operation without pus discharge. Functional and esthetic results showed successful reconstruction.

Multi-Finger 3D Landmark Detection using Bi-Directional Hierarchical Regression

Choi, Jaesung,Lee, Minkyu,Lee, Sangyoun International Society for Simulation Surgery 2016 Journal of International Society for Simulation Su Vol.3 No.1

Purpose In this paper we proposed bi-directional hierarchical regression for accurate human finger landmark detection with only using depth information.Materials and Methods Our algorithm consisted of two different step, initialization and landmark estimation. To detect initial landmark, we used difference of random pixel pair as the feature descriptor. After initialization, 16 landmarks were estimated using cascaded regression methods. To improve accuracy and stability, we proposed bi-directional hierarchical structure.Results In our experiments, the ICVL database were used for evaluation. According to our experimental results, accuracy and stability increased when applying bi-directional hierarchical regression more than typical method on the test set. Especially, errors of each finger tips of hierarchical case significantly decreased more than other methods.Conclusion Our results proved that our proposed method improved accuracy and stability and also could be applied to a large range of applications such as augmented reality and simulation surgery.