Image guided surgical navigation for removal of foreign bodies in the head and neck

Introduction: The removal of foreign bodies in the head and neck area is often a surgical challenge due to a combination of difficult access and a close anatomical relationship of the foreign body to vital structures. Recent developments in computer-assisted surgery (CAS) have brought major improvements to the operating rooms for maxillofacial surgeons. The purpose of this paper is to report our experience in computer assisted removal of foreign bodies from the head and neck area, based on various clinical cases. Patients: Computer assisted removal of foreign bodies from the head and neck area was performed in 11 patients. Three patients sustained gun shot wounds with remaining projectiles or fragments in the soft tissue. In six cases, objects related to a preceding surgical intervention were removed. Two patients presented with dislocated teeth in the facial or cervical soft tissues after 3rd molar surgery. Method: For surgical planning and intra-operative navigation, a computer based image guided surgery system (VectorVision(2(R)), BrainLab) was used. Results: In 10 of 11 cases the foreign bodies could be removed without major complications by a minimal invasive manner. More than 40 % of surgery time could be saved compared to similar interventions operated upon using conventional methods. Conclusion: In our opinion, the use of a computer based image guided surgical system is of great benefit when removing foreign bodies from the head and neck area. The minimally invasive access helps to prevent major complications such as injury to vital structures and allows a quicker operation. (C) 2001 European Association for Cranio-Maxillofacial Surgery.