Intraoperative imaging and navigation with mobile cone-beam CT in maxillofacial surgery.

Intraoperative mobile Cone-Beam Computed Tomography (CBCT) trends to develop for the management of complex facial fractures. It allows a real-time imaging and surgical navigation. Through the presentation of two clinical cases, we aimed at presenting the procedure of intra-operative CBCT and new applications in maxillofacial surgery. A young patient with extended orbito-frontal fibrous dysplasia, and a child with the recurrence of a temporomandibular joint ankylosis secondary to mastoïditis, were operated using a intra-operative imaging control. In both cases, the intraoperative CBCT increased precision and safety of the bone resection. No surgical complication was noted and a good healing was obtained. Intraoperative CBCT raises the problems of radiation exposure and increased operating time. However, it represents a useful imaging tool and a navigation system in complex situations as osseous dysplasia and surgery of the temporo-mandibular joint.