Image-guided navigation for treatment of complex midfacial fractures Ju ¨ rgen Hoffmann a, T , Carsten Westendorff a , Florian Dammann b , Dirk Bartz c , Siegmar Reinert a a Department of Oral and Maxillofacial Plastic Surgery, Tu ¨ bingen University Hospital, Germany b Department of Diagnostic Radiology, Tu ¨ bingen University Hospital, Germany c Wilhelm Schickard Institute for Computer Science, Eberhard-Karls-University Tu ¨ bingen, Germany Abstract. Orbitozygomatic fractures pertain to the most common injuries in craniofacial trauma surgery. Accurate fracture reduction is of high importance for a successful outcome. This pilot study was performed to assess the potential benefit of surgical navigation to aid in orbitozygomatic fracture reduction. Methods: A non-comparative series of 10 consecutive patients with moderately displaced orbitozygomatic fractures was treated using the guidance of computed tomography (CT) based surgical navigation. A newly developed software platform was used for the creation of a preoperative treatment plan. On a computer workstation, the fracture was reduced virtually by three-dimensional shifting of the zygomaticomaxillary complex within the preoperative multimodal CT data set. This treatment plan was transferred to a navigation system. Fracture reduction was performed using surgical navigation according to the treatment plan. Results: Virtual segmentation and positioning of the zygomaticomaxillary complex was easily performed. Intraoperative control of fracture reduction by comparing the real with the virtual preplanned bone position using surgical navigation showed up as a helpful tool. Conclusion: Accurate treatment planning and immediate evaluation of craniofacial surgery outcome are the benefits of the new approach demonstrated. In addition to bone repositioning, a future application may include simulation of craniomaxillofacial osteotomiesness. D 2005 CARS & Elsevier B.V. All rights reserved. Keywords: 3D computerized tomography; Computer assisted surgery; CAS; Midfacial trauma 0531-5131/ D 2005 CARS & Elsevier B.V. All rights reserved. doi:10.1016/j.ics.2005.03.176 T Corresponding author. E-mail address: juergen.hoffmann@uni-tuebingen.de (J. Hoffmann). International Congress Series 1281 (2005) 1227 – 1232 www.ics-elsevier.com