Minna Kääriäinen1, Marika Kuuskeri1, Georgios Gremoutis1, Hannu Kuokkanen1, Aimo Miettinen2, Jussi Laranne3. 1. Department of Plastic and Reconstructive Surgery, Tampere University Hospital, Tampere, Finland. 2. Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland. 3. Department of Otolaryngology, Tampere University Hospital, Tampere, Finland.
Abstract
BACKGROUND: The aim of this study was to analyze the effects of computer-aided three-dimensional virtual planning and the use of customized cutting guides in maxillary and mandibular reconstruction with a microvascular fibula flap. METHODS: Patients (n = 17) undergoing free fibula flap (n = 18) reconstruction of the maxilla (n = 2) or mandible (n = 15) from January 2012 through March 2014 were enrolled in the study. Preoperatively, patients underwent high-resolution computed tomography of the maxillofacial and lower leg regions. Three-dimensional virtual planning of the resection and reconstruction was performed. Customized cutting guides for maxillary/mandibular resections and fibular osteotomies, and prebend plates were manufactured. Demographic data, surgical factors, and perioperative and postoperative results were evaluated. RESULTS: Sixteen patients had malignant disease and one had benign disease. Sixteen of the flaps were osteomuscular and two were osteomusculocutaneous. Mean ischemia time was 99 minutes and mean operative time was 542 minutes. The flaps fitted into the defects precisely and no bone grafts were needed. Mean length of the fibula flap was 74 mm and the mean number of segments in the flap was 2.1. CONCLUSION: Three-dimensional computer-aided preoperative virtual planning allowed for precise planning of the tumor resection and size of the fibula flap, the number and placement of the osteotomies needed, and the manufacture of customized cutting guides. Fibular shaping is easier and faster, which may decrease the ischemia time and total operative time. Exact placement of the flap in the defect may facilitate restoration of the anatomic shape and ossification. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
BACKGROUND: The aim of this study was to analyze the effects of computer-aided three-dimensional virtual planning and the use of customized cutting guides in maxillary and mandibular reconstruction with a microvascular fibula flap. METHODS:Patients (n = 17) undergoing free fibula flap (n = 18) reconstruction of the maxilla (n = 2) or mandible (n = 15) from January 2012 through March 2014 were enrolled in the study. Preoperatively, patients underwent high-resolution computed tomography of the maxillofacial and lower leg regions. Three-dimensional virtual planning of the resection and reconstruction was performed. Customized cutting guides for maxillary/mandibular resections and fibular osteotomies, and prebend plates were manufactured. Demographic data, surgical factors, and perioperative and postoperative results were evaluated. RESULTS: Sixteen patients had malignant disease and one had benign disease. Sixteen of the flaps were osteomuscular and two were osteomusculocutaneous. Mean ischemia time was 99 minutes and mean operative time was 542 minutes. The flaps fitted into the defects precisely and no bone grafts were needed. Mean length of the fibula flap was 74 mm and the mean number of segments in the flap was 2.1. CONCLUSION: Three-dimensional computer-aided preoperative virtual planning allowed for precise planning of the tumor resection and size of the fibula flap, the number and placement of the osteotomies needed, and the manufacture of customized cutting guides. Fibular shaping is easier and faster, which may decrease the ischemia time and total operative time. Exact placement of the flap in the defect may facilitate restoration of the anatomic shape and ossification. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Paolo Iacoviello; Susanna Bacigaluppi; Simone Callegari; Carlo Rossello; Andrea Antonini; Marco Gramegna; Mariano Da Rold; Giuseppe Signorini; Giuseppe Verrina Journal: Front Surg Date: 2022-06-30
Authors: Po Wu; Lin Hu; Hao Li; Lin Feng; Yu Liu; Shuo Zhang; Xue-Chao Li; Mei-Ling Zhang; Shu-Yong Yang; Rong-Jian Lu Journal: Ann Transl Med Date: 2021-03