Template-based registration for image-guided maxillofacial surgery

Purpose: Fiducial marker registration using bone screws is a proved and tested method for patient-to-image registration for image-guided surgery of the head. The use of intraoral fiducial markers mounted on a template for the maxillary dentition is a less invasive alternative and is ill use for intraoral image-guided surgery. The aim of this study was to verify if this method is sufficiently accurate for extraoral use. Materials and Methods: Registration was performed using 243 different configurations of fiducial markers mounted on a maxillary template. The accuracy of the identification of artificial skull-mounted targets located in surgically relevant locations was determined for each registration. Results: Targeting accuracy was sufficient for image-guided surgery of the maxilla, the midface, the orbit, and the pterygopalatine fossa. In the regions of the calvarium, however, average target registration error was >= 1.5 mm. Average target registration error was > 3 mm. Conclusion: Fiducial marker registration based on a maxillary template is it safe and non-invasive alternative to bone-mounted fiducial markers for image-guided surgery in the regions of orbit, face, maxilla, and pterygopalatine fossa. (c) 2005 American Association of Oral and Maxillofacial Sutgeons.