Navigation assisted surgery

[EuroOMFS]

Yesterday, I assisted on one of the coolest cases I´ve been involved with so far. We had a visiting surgeon in who assisted us in doing a secondary reconstruction of the orbit, both the superior and the inferior rim, as well as as the medial wall and floor. The patient had been primarily reconstructed in another country after a traffic accident. The zygoma had been fixed in entirely the wrong position and we did a zygoma osteotomy to move it into position.

Now, the cool thing was the planning of the case, and the navigation part. This visiting OMS who comes from an OMS dept. in Germany, had planned the case using software, where he started out by reconstructing the case in the computer. He then placed bone-fragments and implants with millimeter precision by using computer assisted navigation. I´m pretty convinced it couldn´t have been done with the same precision without this equipment.

Do other OMSs on SDN have experience with this? It´s not new, and I´ve been on meetings where it has been presented, but this was my first experience with it.

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[El Guapo78]

Yesterday, I assisted on one of the coolest cases I´ve been involved with so far. We had a visiting surgeon in who assisted us in doing a secondary reconstruction of the orbit, both the superior and the inferior rim, as well as as the medial wall and floor. The patient had been primarily reconstructed in another country after a traffic accident. The zygoma had been fixed in entirely the wrong position and we did a zygoma osteotomy to move it into position.

Now, the cool thing was the planning of the case, and the navigation part. This visiting OMS who comes from an OMS dept. in Germany, had planned the case using software, where he started out by reconstructing the case in the computer. He then placed bone-fragments and implants with millimeter precision by using computer assisted navigation. I´m pretty convinced it couldn´t have been done with the same precision without this equipment.

Do other OMSs on SDN have experience with this? It´s not new, and I´ve been on meetings where it has been presented, but this was my first experience with it.

Was the Oral Surgeon Dr. Rainier Shmelzeisen (spelling?). I was at a conference in Minnesota where he lectured about this. Seems cool, but way too expensive and impractical for private practice.

 

[EuroOMFS]

Was the Oral Surgeon Dr. Rainier Shmelzeisen (spelling?). I was at a conference in Minnesota where he lectured about this. Seems cool, but way too expensive and impractical for private practice.

Actually it was one of his attendings, Dr. Schoen, from the same unit. It's expensive alright. About 150.000 Euro ($190.000) for the equipment and software (for one of the cheaper models). But the accuracy of this thing is simply unbelievable.

 

[El Guapo78]

Actually it was one of his attendings, Dr. Schoen, from the same unit. It's expensive alright. About 150.000 Euro ($190.000) for the equipment and software (for one of the cheaper models). But the accuracy of this thing is simply unbelievable.

It would be cool, but other than recontruction of extensive defects what would you use it for? Any ideas?
Did he show you guys pictures of there O.R. in germany? It's unreal.

 

[Ankylosed]

It would be cool, but other than recontruction of extensive defects what would you use it for? Any ideas?
Did he show you guys pictures of there O.R. in germany? It's unreal.

It works for total joint arthroplasty also.

 

[EuroOMFS]

It would be cool, but other than recontruction of extensive defects what would you use it for? Any ideas?
Did he show you guys pictures of there O.R. in germany? It's unreal.

You can use it for basically anything. There are people using it in implant surgery and orthognathic surgery. Dr. Shoen uses it also in primary reconstruction surgery (orbital floor defects etc.)

Yep, we saw pictures from Freiburg. I'm hoping to go down there for a few weeks next spring to watch and learn.

 

[scalpel2008]

Yesterday, I assisted on one of the coolest cases I´ve been involved with so far. We had a visiting surgeon in who assisted us in doing a secondary reconstruction of the orbit, both the superior and the inferior rim, as well as as the medial wall and floor. The patient had been primarily reconstructed in another country after a traffic accident. The zygoma had been fixed in entirely the wrong position and we did a zygoma osteotomy to move it into position.

Now, the cool thing was the planning of the case, and the navigation part. This visiting OMS who comes from an OMS dept. in Germany, had planned the case using software, where he started out by reconstructing the case in the computer. He then placed bone-fragments and implants with millimeter precision by using computer assisted navigation. I´m pretty convinced it couldn´t have been done with the same precision without this equipment.

Do other OMSs on SDN have experience with this? It´s not new, and I´ve been on meetings where it has been presented, but this was my first experience with it.

Schmelzeisen gave a talk in 2004 about this in Whistler, BC at the AO Advanced Symposium:Advances in the Management of Craniomaxillofacial Surgery. Very cool stuff. Also in this month's JOMS, there is a similar application for TMJ. The problem is that in the US this would be very difficult. In Europe, as you may be able to confirm this, there are "Centers" for each specialty. In other words, there are few hospitals where the majority of OMS is performed, and therefore they have a lot more Government $$$. These places literally have multiple floors just dedicated to OMS, or ENT, or whatever. However, in the US, we don't typically have such "Centers" especially for OMS (we do for head and neck cancer etc.). Therefore cost is always an issue.
The next advanced AO symposium is in Lake Tahoe in February. I'll be there. This symposium is once a year and I think it's by far the best craniomaxillofacial trauma meeting. Schmelzeisen, along with many other ENTs, PRS, and OMS from all over the world will be there to strut their stuff.

 

[IcedOMFS]

Schmelze
The next advanced AO symposium is in Lake Tahoe in February. I'll be there. This symposium is once a year and I think it's by far the best craniomaxillofacial trauma meeting. Schmelzeisen, along with many other ENTs, PRS, and OMS from all over the world will be there to strut their stuff.

Better than their master course in Davos, Switzerland?

 

[scalpel2008]

Better than their master course in Davos, Switzerland?

I've not attended the Davos course. I guess I was talking about the US. The Davos course is 5 days because it's a combination of the basic and advanced courses. The advanced course here doesn't waste your time with ernst ligatures, and arch bars/plates on saw bone. I felt the quality of lectures were good although the allotted time for each topic isn't adequate. This year it seems like they've cut back on the trauma and added more esthetic and OSA stuff. In Whistler, we had a 4 hour break between the AM and PM lectures to allow time for skiing/snowboarding (i'm sure Davos does the same)