Preoperative head and neck surgical planning with computer-assisted design and modeling

Virtual surgical planning (VSP) has significantly impacted modern head and neck surgery. Over the past decade, advancements in computer-assisted design (CAD) software have been applied to high-resolution threedimensional imaging technology to generate powerful tools for planning complex craniofacial resections and reconstructions. These virtual surgical plans incorporate the design of intraoperative surgical guides that are generated through the process of computer-assisted manufacturing (CAM). Virtually planned procedures are then translated to the operating room where they are carried out with unparalleled precision and efficiency. This process allows for accurate operative design that reliably achieves predicted results. Surgical teams are now able to formulate single-staged ablative/reconstructive procedures all the way through to prosthetic dentition and expected soft-tissue outcomes. Recent studies have demonstrated the benefits of preoperative CAD/CAM surgical planning for oncologic resections with immediate reconstructions, severe facial trauma, complex orthognathic and temporomandibular joint procedures, esthetic surgery, and composite tissue allotransplantation. We provide an overview of CAD/CAM applications in head and neck surgery and review the evidence to date regarding the use of preoperative VSP in complex craniofacial reconstruction.