Bone segment navigation

Bone segment navigation is a surgical method used to find the anatomical position of displaced bone fragments in fractures, or to position surgically created fragments in craniofacial surgery. Such fragments are later fixed in position by osteosynthesis. It has been developed for use in craniofacial and oral and maxillofacial surgery.

Bone segment navigation is a patented [1][2] surgical procedure, using a frameless and markerless registration technique. It uses for the first time natural registration surfaces instead of single artificial x-ray visible markers, in order to achieve a higher precision (1 mm and better).[3] Previous methods of Cutting and Watzinger do not meet the criteria of bone segment navigation.[4]

After an accident or injury, a fracture can be produced and the resulting bony fragments can be displaced. In the oral and maxillofacial area, such a displacement could have a major effect both on facial aesthetics and organ function: a fracture occurring in a bone that delimits the orbit can lead to diplopia; a mandibular fracture can induce significant modifications of the dental occlusion; in the same manner, a skull (neurocranium) fracture can produce an increased intracranial pressure.[citation needed]

In severe congenital malformations of the facial skeleton surgical creation of usually multiple[5][6] bone segments is required with precise movement of these segments to produce a more normal face.

  1. ^ Marmulla R (inventor), Carl Zeiss (submitter): System and method for bone segment navigation. United States Patent 6.241.735, 2001.
  2. ^ Marmulla R and Lüth T: Method and device for instrument, bone segment, tissue, and organ navigation, United States Patent 7.079.885, 2006
  3. ^ Marmulla R, Niederdellmann H: Computer-assisted Bone Segment Navigation. In: Journal of Cranio-Maxillo-Facial Surgery. 1998; 26, S. 347–359.
  4. ^ Marmulla R: Knochensegmentnavigation. Quintessenz-Verlag, Berlin 2000, ISBN 3-87652-869-0.
  5. ^ Obwegeser, HL (1969). "Surgical correction of small or retrodisplaced maxillae. The "dish-face" deformity". Plast Reconstr Surg. 43 (4): 351–65. doi:10.1097/00006534-196904000-00003. PMID 5776622. S2CID 41856712.
  6. ^ Cutting, C; Grayson, B; Bookstein, F; Kim, H; McCarthy, J (1991). "The case for multiple cranio-maxillary osteotomies in Crouzon's disease.". In Caronni, EP (ed.). Craniofacial Surgery 3. Bologna: Monduzzi Editore. ISBN 9788832300000.