Gerald Thomas Grant DMD, MS, Presenter: Nothing to Disclose

Peter Constantine Liacouras PhD, Abstract Co-Author: Nothing to Disclose

Ryan J. Murphy MS, Abstract Co-Author: Nothing to Disclose

Chad R Gordon DO, Abstract Co-Author: Nothing to Disclose

Mehran Armand PhD, Abstract Co-Author: Nothing to Disclose

Proper alignment of the donor and recipient bony anatomy could potentially decrease future complications and provide a screening tool if multiple donors are available. In efforts to achieve proper alignment, custom surgical guides can be designed and manufactured allowing surgeons to identify and transect precisely on predetermined planes. In addition, earlier identification and surgical cuts will decrease surgical times.

Craniomaxillofacial allotransplantation is currently a new and challenging procedure. Presently, more than twenty patients have received full or partial face transplants. Recently, one of the most current focuses of this procedure is the refinement of the methods and surgical technique used. Creating an optimal hybrid occlusion and facial proportions is difficult and benefits greatly from pre-surgical planning. Using radiographic tools, Digital Software, and Additive Manufacturing (3D Printing) many of the complex steps in these surgeries can be planned in advance.

CT scans of two deidentified cadaver heads were converted with segmentation software to gernerate volume data used for preoperative planning and visualization.  One fo the scans was designated as a recipient with a maxillofacial defect.  Surgical planes are developed and located on the recipient scann.  The intact donor volume is then registerd to the recipient scan maintaining the cut planes for the best fit of donor to recipient.   

Registering the donor scan to the recipient provides the opportunity to evaluate the best fit of donor to recipient.  In a situation where there may be multiple donors available, this technique could provide another screening of the donors as one may be a better fit than another.  Since the cutting planes slice through both the donor and recipient, by adjusting the plane cuts to accomodate the cutting blades, the guides provide the best opportunity for exacting fit of the two boney sections.

Grant, G, Liacouras, P, Murphy, R, Gordon, C, Armand, M, Planning Complex Surgical Cutting Guides for Le Forte-Based, Maxillofacial Transplantation.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014291.html