Virtual planning of facial reconstructions

In craniofacial surgery it is not easy to predict the shape of the postoperative face, as muscular changes resulting from the surgery cannot be found by a simple way. Three-dimensional (3D) computer simulation of craniofacial surgery can be extremely useful to foresee the surgical outcome. Many authors proposed computer systems for craniofacial surgical planning based on computed tomographic (CT) images. A number of methods to achieve the prediction of soft tissue behaviour have been proposed from computer-aided surgical planning system integrating anatomy-based 3D finite element tissue model to methods for computation of soft-tissue deformation in craniofacial surgery directly from CT images without any intermediate geometric model. We present a review of present techniques on the use of imaging in the presurgical planning of facial surgery and reconstruction. The entire workflow of image acquisition, tissue segmentation, tissue classification, surgical planning, soft tissue displacement computer simulation and visualization is outlined and different cases of real maxillofacial surgery are illustrated. © 2007 Blackwell Publishing Ltd.