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Surgical Navigation, Augmented Reality, and 3D Printing for Hard Palate Adenoid Cystic Carcinoma En-Bloc Resection: Case Report and Literature Review

Adenoid Cystic Carcinoma is a rare and aggressive tumor representing less than 1% of head and neck cancers. This malignancy often arises from the minor salivary glands, being the palate its most common location. Surgical en-bloc resection with clear margins is the primary treatment. However, this lo...

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Autores principales: García-Sevilla, Mónica, Moreta-Martinez, Rafael, García-Mato, David, Arenas de Frutos, Gema, Ochandiano, Santiago, Navarro-Cuéllar, Carlos, Sanjuán de Moreta, Guillermo, Pascau, Javier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763795/
https://www.ncbi.nlm.nih.gov/pubmed/35059309
http://dx.doi.org/10.3389/fonc.2021.741191
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author García-Sevilla, Mónica
Moreta-Martinez, Rafael
García-Mato, David
Arenas de Frutos, Gema
Ochandiano, Santiago
Navarro-Cuéllar, Carlos
Sanjuán de Moreta, Guillermo
Pascau, Javier
author_facet García-Sevilla, Mónica
Moreta-Martinez, Rafael
García-Mato, David
Arenas de Frutos, Gema
Ochandiano, Santiago
Navarro-Cuéllar, Carlos
Sanjuán de Moreta, Guillermo
Pascau, Javier
author_sort García-Sevilla, Mónica
collection PubMed
description Adenoid Cystic Carcinoma is a rare and aggressive tumor representing less than 1% of head and neck cancers. This malignancy often arises from the minor salivary glands, being the palate its most common location. Surgical en-bloc resection with clear margins is the primary treatment. However, this location presents a limited line of sight and a high risk of injuries, making the surgical procedure challenging. In this context, technologies such as intraoperative navigation can become an effective tool, reducing morbidity and improving the safety and accuracy of the procedure. Although their use is extended in fields such as neurosurgery, their application in maxillofacial surgery has not been widely evidenced. One reason is the need to rigidly fixate a navigation reference to the patient, which often entails an invasive setup. In this work, we studied three alternative and less invasive setups using optical tracking, 3D printing and augmented reality. We evaluated their precision in a patient-specific phantom, obtaining errors below 1 mm. The optimum setup was finally applied in a clinical case, where the navigation software was used to guide the tumor resection. Points were collected along the surgical margins after resection and compared with the real ones identified in the postoperative CT. Distances of less than 2 mm were obtained in 90% of the samples. Moreover, the navigation provided confidence to the surgeons, who could then undertake a less invasive and more conservative approach. The postoperative CT scans showed adequate resection margins and confirmed that the patient is free of disease after two years of follow-up.
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spelling pubmed-87637952022-01-19 Surgical Navigation, Augmented Reality, and 3D Printing for Hard Palate Adenoid Cystic Carcinoma En-Bloc Resection: Case Report and Literature Review García-Sevilla, Mónica Moreta-Martinez, Rafael García-Mato, David Arenas de Frutos, Gema Ochandiano, Santiago Navarro-Cuéllar, Carlos Sanjuán de Moreta, Guillermo Pascau, Javier Front Oncol Oncology Adenoid Cystic Carcinoma is a rare and aggressive tumor representing less than 1% of head and neck cancers. This malignancy often arises from the minor salivary glands, being the palate its most common location. Surgical en-bloc resection with clear margins is the primary treatment. However, this location presents a limited line of sight and a high risk of injuries, making the surgical procedure challenging. In this context, technologies such as intraoperative navigation can become an effective tool, reducing morbidity and improving the safety and accuracy of the procedure. Although their use is extended in fields such as neurosurgery, their application in maxillofacial surgery has not been widely evidenced. One reason is the need to rigidly fixate a navigation reference to the patient, which often entails an invasive setup. In this work, we studied three alternative and less invasive setups using optical tracking, 3D printing and augmented reality. We evaluated their precision in a patient-specific phantom, obtaining errors below 1 mm. The optimum setup was finally applied in a clinical case, where the navigation software was used to guide the tumor resection. Points were collected along the surgical margins after resection and compared with the real ones identified in the postoperative CT. Distances of less than 2 mm were obtained in 90% of the samples. Moreover, the navigation provided confidence to the surgeons, who could then undertake a less invasive and more conservative approach. The postoperative CT scans showed adequate resection margins and confirmed that the patient is free of disease after two years of follow-up. Frontiers Media S.A. 2022-01-04 /pmc/articles/PMC8763795/ /pubmed/35059309 http://dx.doi.org/10.3389/fonc.2021.741191 Text en Copyright © 2022 García-Sevilla, Moreta-Martinez, García-Mato, Arenas de Frutos, Ochandiano, Navarro-Cuéllar, Sanjuán de Moreta and Pascau https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
García-Sevilla, Mónica
Moreta-Martinez, Rafael
García-Mato, David
Arenas de Frutos, Gema
Ochandiano, Santiago
Navarro-Cuéllar, Carlos
Sanjuán de Moreta, Guillermo
Pascau, Javier
Surgical Navigation, Augmented Reality, and 3D Printing for Hard Palate Adenoid Cystic Carcinoma En-Bloc Resection: Case Report and Literature Review
title Surgical Navigation, Augmented Reality, and 3D Printing for Hard Palate Adenoid Cystic Carcinoma En-Bloc Resection: Case Report and Literature Review
title_full Surgical Navigation, Augmented Reality, and 3D Printing for Hard Palate Adenoid Cystic Carcinoma En-Bloc Resection: Case Report and Literature Review
title_fullStr Surgical Navigation, Augmented Reality, and 3D Printing for Hard Palate Adenoid Cystic Carcinoma En-Bloc Resection: Case Report and Literature Review
title_full_unstemmed Surgical Navigation, Augmented Reality, and 3D Printing for Hard Palate Adenoid Cystic Carcinoma En-Bloc Resection: Case Report and Literature Review
title_short Surgical Navigation, Augmented Reality, and 3D Printing for Hard Palate Adenoid Cystic Carcinoma En-Bloc Resection: Case Report and Literature Review
title_sort surgical navigation, augmented reality, and 3d printing for hard palate adenoid cystic carcinoma en-bloc resection: case report and literature review
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763795/
https://www.ncbi.nlm.nih.gov/pubmed/35059309
http://dx.doi.org/10.3389/fonc.2021.741191
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