Three-dimensional imaging in craniofacial surgery.

Over the past decade, three-dimensional (3-D) imaging has been developed to such a stage of perfection and to such a level of interactive selective imaging of specific anatomic and pathologic structures that craniofacial surgeons can now use this technique effectively in the planning of complicated reconstructive surgery. In addition, modeling techniques have been devised that can be used in surgical simulation and in the manufacture of implants and prosthetic devices. The technical aspects of 3-D imaging are discussed in relation to their applications in craniofacial surgery, and reference is made to the literature describing these techniques in full detail. The results are illustrated with cases that the authors have processed by means of: (a) a clinical research program that was developed on a general purpose computer which provided full flexibility in changing and improving the reconstruction algorithms (Lobregt algorithms and DEC VAX 750 computer), (b) a system under development (Pixar PICS 2000), and (c) a commercial system (Cemax 1500X). Finally, a number of emerging techniques are discussed such as surgical stimulation (electronic sculpting), and trends such as multimodality imaging.