Abstract
BackgroundOral and maxillofacial surgeons often encounter foreign objects within the human body. Despite the visual identification of foreign objects via imaging techniques, the accurate determination of their position in the maxillofacial area can be challenging. The clinical application of a navigation system can solve this issue. This system provides a useful guide for a safer and more accurate surgical technique by accurately determining the location of the lesion in real time during the surgery. However, complications with regard to registration may be encountered. We describe a navigation system that simplifies registration using a dental splint with embedded reference points for foreign body removal in the maxilla.Case presentationA 78-year-old Japanese woman was referred with the chief complaint of pain in the left upper molar region. We found the symptoms to be associated with a foreign body in the maxilla and decided to remove it. A minimally invasive treatment procedure was desirable. However, the lesion was in contact with the maxillary sinus, and it was difficult to pinpoint its position because of the absence of an anatomical landmark. Therefore, we decided to use a navigation system. In order to simplify registration, a dental splint with embedded reference points was created. The registration could be reliably performed before surgery using an optical navigation system that facilitates the process, using splints with embedded reference points. Following preoperative registration, the splint with the reference frame was placed in the patient’s mouth, and the accuracy of the navigation was confirmed. The position with respect to the maxillary sinus was precisely identified followed by the removal of the surrounding bone and excision of the lesion. Therefore, the surgery could be accurately performed without perforating the maxillary sinus. In addition, owing to preoperative registration, the operative time could be shortened. After the surgical procedure, the patient’s symptoms disappeared.ConclusionsThe procedure was performed in a precise, minimally invasive manner. Furthermore, the operative time was reduced by the simplified registration process, wherein a splint was embedded with reference points. This technique may prove useful for performing maxillofacial surgical procedures.
Highlights
Oral and maxillofacial surgeons often encounter foreign objects within the human body
We describe a navigation system that simplifies registration using a dental splint with embedded reference points for the removal of a foreign body in the maxilla
Various imaging modalities are selected on the basis of size, composition, and anatomic relation of the foreign bodies to different vital structures [9], computed tomograms (CT) imaging is the gold standard for the detection of foreign bodies [8, 10]
Summary
Oral and maxillofacial surgeons often encounter foreign objects within the human body. The clinical application of a navigation system can solve this issue This system provides a useful guide for a safer and more accurate surgical technique by accurately determining the location of the lesion in real time during the surgery. The most commonly retained foreign objects in the body are wood splinters, glass fragments, and metal substances [1] They are generally found to occur as a result of traffic accidents, assaults, bullet wounds, and iatrogenic dental injuries [2]. The execution and predictability of surgical procedures has improved, allowing for more precision during maxillofacial surgery [5]. Complications such as registration and deterioration of accuracy are important issues during intraoperative navigation
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