A Simulation Environment for Maxillofacial Surgery Including Soft Tissue Implications

This paper describes work in progress in the area of planning and prediction of maxillofacial surgery. We focus on true 3D problems which cannot be addressed by conventional 2D cephalometric radiographs. Examples are bilateral repositioning of the zygoma's or treating facial asymmetries. The environment being developed arose from the need of patients for prediction of their expected post-op outlook and from the need of surgeons for better support to reach the desired result. Our simulation environment adheres to a scene-based approach in which CT image-derived visualizations and additional 3D photographs (showing the face surface and its natural complexion) are co-presented and manipulated. Tools for non-planar osteotomy are included. Repositioning of bone fragments is made possible. Furthermore, a voxel displacement formalism is presented to account for soft tissue implications. Combining these simulation tools, a qualitative prediction of the facial outlook is obtained. Results are shown for a case of hypoplastic zygoma repositioning.