Navigation-guided osteotomies improve margin delineation in tumors involving the sinonasal area: A preclinical study.
Oral Oncol
; 99: 104463, 2019 12.
Article
en En
| MEDLINE
| ID: mdl-31683173
ABSTRACT
OBJECTIVES:
To demonstrate and quantify, in a preclinical setting, the benefit of three-dimensional (3D) navigation guidance for margin delineation during ablative open surgery for advanced sinonasal cancer. MATERIALS ANDMETHODS:
Seven tumor models were created. 3D images were acquired with cone beam computed tomography, and 3D tumor segmentations were contoured. Eight surgeons with variable experience were recruited for the simulation of osteotomies. Three simulations were performed 1) Unguided, 2) Guided using real-time tool tracking with 3D tumor segmentation (tumor-guided), and 3) Guided by 3D visualization of both the tumor and 1-cm margin segmentations (margin-guided). Analysis of cutting planes was performed and distance from the tumor surface was classified as follows "intratumoral" when 0â¯mm or negative, "close" when greater than 0â¯mm and less than or equal to 5â¯mm, "adequate" when greater than 5â¯mm and less than or equal to 15â¯mm, and "excessive" over 15â¯mm. The three techniques (unguided, tumor-guided, margin-guided) were statistically compared.RESULTS:
The use of 3D navigation for margin delineation significantly improved control of margins unguided cuts had 18.1% intratumoral cuts compared to 0% intratumoral cuts with 3D navigation (pâ¯<â¯0.0001).CONCLUSION:
This preclinical study has demonstrated the significant benefit of navigation-guided osteotomies for sinonasal tumors. Translation into the clinical setting - with rigorous assessment of oncological outcomes - would be the proposed next step.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Osteotomía
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Senos Paranasales
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Márgenes de Escisión
Tipo de estudio:
Guideline
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Prognostic_studies
Límite:
Female
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Humans
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Male
Idioma:
En
Revista:
Oral Oncol
Asunto de la revista:
NEOPLASIAS
Año:
2019
Tipo del documento:
Article