Purpose: The K-wire technique for fixation of rib cartilage grafts to the maxilla is a powerful tool in rhinoplasty. However, the technique is challenging because of poor maxillary visualization through the open rhinoplasty approach. This study evaluates the efficacy of a surgical navigation to guide K-wire placement.

Methods/Materials: K-Wires were placed into the maxillas of twelve fresh cadaver heads by a surgical resident. Six control specimens had K-wires placed without navigation. Six treatment specimens had K-wires placed with the “look-ahead navigation,” in which a navigation was attached to the K-wire gun. All maxillas were then sectioned to determine K-wires' final location.

Results: 80% of the K-wires were successfully placed in the treatment group, while only 50% of the K-wires were successfully placed in the control group. The average K-wire deviation in the axial plane was less for the treatment group (0.2 ± 0.4 mm) than for the control group (1.8 ±1.5 mm) (p<0.05). The average depth of penetration for the treatment group was 7.6 ± 1.9 mm, while for the control group, it was 11.7± 6.1 mm (p>0.05).

Conclusion: When surgical navigation is used in K-wired cartilage strut graft placement to maxilla, it can improve the accuracy of K-wire placement.