3D surgical planning in patients affected by lipodystrophy

Lipodystrophy is a pathological condition characterized by the focal or general absence of adipose tissue. Surgeons reset the patient's surface contours using injectable materials to recreate a normal physical appearance. However, due to difficulties in preoperative planning and intraoperative assessment, about 15% of the surgical procedures involved are reinterventions to improve volume or symmetry. This increases the need for an available, efficient tool capable of providing the surgeon with a good estimation of the volumes to be injected before the intervention proper begins. This work describes a virtual reality-based application for the surgical planning of facial lipodystrophy correction (FLIC). The tool uses points selected interactively by the surgeon to compute a curve that delimits the surface area to be operated on. It then automatically computes an estimated natural reconstructed surface and the quantity of volume that needs to be implanted during the intervention. Experiments have been carried out in which the filling volumes estimated using FLIC and ZBrush software were compared with the real volumes injected by the surgeon. ICCs higher than 0.97 indicate that there were no significant differences between the respective measurements, thus validating the tool proposed in this paper. (C) 2015 Elsevier Ltd. All rights reserved.