Navident used in a pioneering facial prosthesis surgery

Navident helped a very unfortunate patient to, hopefully, regain some freedom and dignity in a world first surgery at Sunnybrook Hospital

New surgical navigation system may help improve use of life-like facial prosthetics
April 11, 2018 by Alexis Dobranowski
Sunnybrook Magazine – Spring 2018

Brenda’s latest experience felt similar to the 12 surgeries before. She was anaesthetized and fast asleep. But for the surgical team, it was a whole new ball game.

Brenda was the first patient at Sunnybrook – and in the world – where surgeons used a state-of-the-art navigation system to help guide the placement of two 3-millimetre screws.

As a prosthodontic resident (a dentist who specializes in the replacement of teeth) and a master’s student at the University of Toronto, Dr. Eszter Somogyi-Ganss participated in the creation and evaluation of a new navigational system that allows surgeons to connect a previous CT image to the patient’s anatomy in real time and then easily navigate the implants to the bone on the patient’s face. Designed for use in dentistry, the system is currently being modified and tweaked for use in other facial surgeries.

Now a maxillofacial prosthodontist in Sunnybrook’s Craniofacial Prosthetics Unit in the Department of Dentistry, Dr. Somogyi-Ganss works with surgeons to examine CT images and plan where best to place the surgical screws. The team then loads up the plan into the navigation system and it guides their hands and drill to the right spot.

“To place surgical implants, the surgeon may have to drill up or down or sideways,” she explains. “This computer-guided system tells the surgeon: ‘Drill here. Drill this deep. Drill on this angle.’”

And it all happens in real time.

“This system is like a glide path in an aircraft,” says Dr. Kevin Higgins, one of the head and neck surgeons at Sunnybrook who performed Brenda’s surgery. “You have your flight path, and if there’s any deviation, you get an alert. It tells you to stop. This surgical system guides exactly how you are holding the drill – the pitch, the yaw and the roll – so you get optimal placement. It’s taking precision placement to the next level.”