How to use 3D CT navigation for oral and maxillofacial treatment?

  With the rapid development of science and technology, the traditional concept of surgery has been greatly challenged. The concept of minimally invasive has been deeply penetrated into all fields of surgical diagnosis and treatment, and surgical procedures are moving in the direction of becoming more and more delicate and precise. In recent years, the rapid development of medical imaging technology, image processing technology began to be applied to the medical field, gradually formed a computer-assisted navigation system (Computer assisted navigation system, CANS). At present, only a few hospitals in China have 3D-CT navigation system (Accuracy 3D-CT navigation system) because the equipment is more expensive, and 3D-CT navigation technology has only been applied in a few departments such as neurosurgery and orthopedics.  Director Zhang Hai Zhong, Deputy Chief Physician Bu Jing Qiu and Dr. Chen Peng were the first to apply the German Brain LAB 3D-CT navigation system in oral and maxillofacial surgery in China, which further advanced the oral and maxillofacial surgery to the direction of minimally invasive, rapid, safe and precise. A series of oral and maxillofacial surgeries have been successfully performed with good results.  The working principle of 3D CT navigation system is to use the preoperative image information (CT, enhanced CT) obtained by digital scanning technology to input to the core of the system through CD-ROM – a powerful computer workstation, which reconstructs the 3D model image of the patient after high-speed computing processing, and the surgeon can operate the relevant software to perform the surgery based on this image. The surgeon can operate the relevant software for preoperative planning (multiple surgical planning routes can be set) and simulate the process on the basis of this image, and during the actual surgery the system infrared camera dynamically tracks the current position of the surgical instruments relative to the patient’s anatomy and clearly displays it on the patient’s 2D/3D image data, and the surgeon observes the current surgical approach and various parameters (angle, depth, etc.) from all directions through the high-definition display screen, thus maximizing the surgical approach. The surgeon observes the current surgical approach and various parameters (angle, depth, etc.) from all directions through the high-definition display, so as to avoid the danger zone to the maximum extent, reach the target lesion in the shortest time, greatly reduce the patient’s blood loss and surgical trauma and complications, and complete the minimally invasive surgery in the true sense.  The 3D CT navigation system combines many high-tech means and has the following advantages: ① enables doctors to make detailed preoperative plans; ② makes surgery more precise, safe, effective and minimally invasive; ③ simplifies surgical operations and reduces the physical, mental and time burdens of doctors and patients; ④ patients only have one CT examination before surgery, which greatly reduces the radiation dose; ⑤ may enable good treatment of diseases that are difficult to treat with conventional surgery; ⑥ Shorten the postoperative hospitalization and recovery time.  The projects that have been carried out by the group of Director Zhang Hai Zhong using 3D CT navigation system include: (1) the application of 3D CT navigation system for radioactive particle implantation for malignant tumors; (2) the corresponding treatment for trigeminal neuralgia patients by 3D CT navigation for the nerve segments in the cranial exit area of the trigeminal nerve such as the round hole and the foramen ovale at the base of the skull; (3) the application of 3D CT navigation system for the removal of foreign bodies from the oral and maxillofacial area. At present, Director Zhang Hai Zhong has accumulated rich experience in applying 3D CT navigation system to perform a variety of oral and maxillofacial surgeries, and his techniques and experiences have been exchanged in academic conferences at home and abroad for many times, which have been unanimously praised by experts and scholars at home and abroad. His practice continues to expand and he has made outstanding contributions to the goal of minimally invasive, rapid, safe and accurate oral and maxillofacial surgery.