Literature DB >> 17113445

Cost-effectiveness analysis for computer-aided surgical simulation in complex cranio-maxillofacial surgery.

James J Xia1, Carl V Phillips, Jaime Gateno, John F Teichgraeber, Andrew M Christensen, Michael J Gliddon, Jeremy J Lemoine, Michael A K Liebschner.   

Abstract

PURPOSE: The purpose of this study is to assess the costs and benefits of computer-aided surgical simulation (CASS) and to compare it with the current surgical planning methods for complex cranio-maxillofacial (CMF) surgery.
MATERIALS AND METHODS: The comparison of methods applies to all CMF surgeries where the patient's condition is severe enough to undergo a computed tomography scan and a stereolithographic model is necessary for the surgical planning process. The costs for each method can be divided into time and other costs. The time was estimated based on the authors' experience as well as on a survey of a small group of 6 experienced CMF surgeons in the United States. The other costs were estimated based on the authors' experience.
RESULTS: CASS has lower costs in terms of surgeon time, patient time, and material costs. Specifically, total surgeon hours spent in planning are 5.25 hours compared with 9.75 for current standard methods. Material and scanning costs are Dollars 1,900 for CASS compared with about Dollars 3,510 for standard methods. Patient time for planning is reduced from 4.75 hours to 2.25 hours with CASS. The reduction in both time and other costs remains when the fixed fee costs of CASS are added to the variable costs. Amortized across the 600 patients per year (1,800 for the assumed 3-year life of the training and software), this adds only a few dollars and a fraction of an hour per surgery. Even in the case of a small clinic when the cost is amortized for 6 patients per year (18 patients for the assumed 3-year life of the training and software), the per surgery costs (9.65 hours and Dollars 2,456) will still favor CASS.
CONCLUSION: Any great new design should consist of at least 2 of the 3 following features: faster, cheaper, and better outcome. This analysis demonstrates that CASS is faster and less costly than the current standard planning methods for complex CMF surgery. Previous studies have also shown that CASS results in better surgical outcomes. Thus, in all regards, CASS appears to be at least as good as the current methods of surgical planning.

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Year:  2006        PMID: 17113445     DOI: 10.1016/j.joms.2005.12.072

Source DB:  PubMed          Journal:  J Oral Maxillofac Surg        ISSN: 0278-2391            Impact factor:   1.895


  23 in total

Review 1.  Maxillofacial surgery simulation using a mass-spring model derived from continuum and the scaled displacement method.

Authors:  G San Vicente; C Buchart; D Borro; J T Celigüeta
Journal:  Int J Comput Assist Radiol Surg       Date:  2008-10-28       Impact factor: 2.924

2.  Customized virtual surgical planning in bimaxillary orthognathic surgery: a prospective randomized trial.

Authors:  Daniel Schneider; Peer W Kämmerer; Matthias Hennig; Gerhard Schön; Daniel G E Thiem; Reinhard Bschorer
Journal:  Clin Oral Investig       Date:  2018-11-15       Impact factor: 3.573

3.  Comparison of actual surgical outcomes and 3-dimensional surgical simulations.

Authors:  Scott Tucker; Lucia Helena Soares Cevidanes; Martin Styner; Hyungmin Kim; Mauricio Reyes; William Proffit; Timothy Turvey
Journal:  J Oral Maxillofac Surg       Date:  2010-06-29       Impact factor: 1.895

4.  Outcomes of conventional versus virtual surgical planning of orthognathic surgery using surgery-first approach for class III asymmetry.

Authors:  Yu-Fang Liao; Ying-An Chen; Yi-Chieh Chen; Yu-Ray Chen
Journal:  Clin Oral Investig       Date:  2020-02-25       Impact factor: 3.573

5.  Three-dimensional surgical simulation.

Authors:  Lucia H C Cevidanes; Scott Tucker; Martin Styner; Hyungmin Kim; Jonas Chapuis; Mauricio Reyes; William Proffit; Timothy Turvey; Michael Jaskolka
Journal:  Am J Orthod Dentofacial Orthop       Date:  2010-09       Impact factor: 2.650

Review 6.  Current Orthognathic Practice in India: Do We Need to Change?

Authors:  Philip Mathew; Paul C Mathai; Jisha David; Usha Shenoy; Rahul Tiwari
Journal:  J Maxillofac Oral Surg       Date:  2019-08-17

7.  New Methods to Evaluate Craniofacial Deformity and to Plan Surgical Correction.

Authors:  Jaime Gateno; James J Xia; John F Teichgraeber
Journal:  Semin Orthod       Date:  2011-09-01       Impact factor: 0.970

8.  Outcome study of computer-aided surgical simulation in the treatment of patients with craniomaxillofacial deformities.

Authors:  James J Xia; Liza Shevchenko; Jaime Gateno; John F Teichgraeber; Terry D Taylor; Robert E Lasky; Jeryl D English; Chung H Kau; Kathleen R McGrory
Journal:  J Oral Maxillofac Surg       Date:  2011-07       Impact factor: 1.895

9.  Comparison of intraoperative time measurements between osseous reconstructions with free fibula flaps applying computer-aided designed/computer-aided manufactured and conventional techniques.

Authors:  Jan Rustemeyer; Aynur Sari-Rieger; Alex Melenberg; Alexander Busch
Journal:  Oral Maxillofac Surg       Date:  2015-04-12

10.  New clinical protocol to evaluate craniomaxillofacial deformity and plan surgical correction.

Authors:  James J Xia; Jaime Gateno; John F Teichgraeber
Journal:  J Oral Maxillofac Surg       Date:  2009-10       Impact factor: 1.895

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