Virtual Planning in Surgical Management of Cleft Lip and Palate
DOI:
https://doi.org/10.63682/jns.v14i33S.10614Keywords:
Cleft lip and palate, Computer-aided design, Craniofacial surgery, Digital surgical planning, Orthognathic surgery, Three-dimensional imaging, Virtual surgical planningAbstract
Background:
Virtual surgical planning (VSP) has increasingly been incorporated into cleft-related surgery to improve preoperative visualization, anatomical planning, and intraoperative execution. This study evaluated the clinical and surgical outcomes associated with VSP compared with conventional surgical planning.
Materials & Methods:
A total of 60 participants were evaluated and divided into two groups of 30 each: Group I underwent conventional surgical planning, whereas Group II underwent VSP. Baseline demographic and clinical characteristics, preoperative planning accuracy, intraoperative parameters, postoperative facial symmetry, complications, and patient/parent satisfaction were compared between the groups. Multivariable logistic regression was performed to identify factors independently associated with major intraoperative modification.
Results:
The groups were comparable regarding age, sex, cleft laterality, and cleft completeness probability (p) >0.05). Overall planning accuracy was significantly higher with VSP than conventional planning (91.8 ± 5.4% vs. 78.6 ± 8.7%; p<0.001), with smaller predicted lip, nasal base, and alveolar discrepancies (all p<0.001). Intraoperative modification was required less frequently with VSP (13.3% vs. 40.0%; p=0.019). Operative duration was shorter in the VSP group (108.6 ± 19.3 vs.
128.4 ± 24.7 minutes; p=0.001), with fewer intraoperative corrections (1.0 ± 0.7 vs. 2.1 ± 1.0; p<0.001) and unplanned surgical changes (10.0% vs. 33.3%; p=0.028). Lip, nasal, and overall facial symmetry scores were significantly higher with VSP (all p<0.001). Patient/parent satisfaction was also greater with VSP (8.3 ± 1.0 vs. 7.0 ± 1.4; p<0.001). Postoperative complications did not differ significantly between groups (p=0.136). Multivariable analysis showed that VSP was independently associated with lower odds of major intraoperative modification (adjusted odds ratio OR = 0.31, 95% confidence interval CI: 0.12–0.78; p = 0.014).
Conclusion:
VSP was associated with improved preoperative planning accuracy, more efficient intraoperative management, better postoperative facial symmetry, and greater patient/parent satisfaction. Its independent association with reduced major intraoperative modification further supports its potential role in digitally assisted cleft surgery.
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