Yao Yu1, Wen-Bo Zhang1, Xiao-Jing Liu2, Chuan-Bin Guo3, Guang-Yan Yu3, Xin Peng4. 1. Resident, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China. 2. Associate Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China. 3. Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China. 4. Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China. Electronic address: pxpengxin@263.net.
Abstract
PURPOSE: Although free fibula flaps are widely used for mandibular reconstruction, their 3-dimensional position is difficult to control during conventional surgery. We aimed to improve this process by using computer-aided design (CAD) and surgical navigation. PATIENTS AND METHODS: We retrospectively reviewed 29 benign tumor patients who underwent primary unilateral mandibular reconstruction with free fibula flap. They were divided into 3 groups: group A, comprising 10 patients, underwent reconstruction based on the surgeon's experience; group B, comprising 7 patients, underwent reconstruction based on CAD; and group C, comprising 12 patients, underwent reconstruction based on CAD and surgical navigation. Condyle and gonion positions and mandibular angles were measured. Operative times were recorded. RESULTS: Among the 17 patients who underwent condylar resection, the average condyle shift was greater in group A than in groups B and C (P < .05). The average gonion shift was greater in groups A and B than in group C (P < .05). The difference between the reconstructed and contralateral mandibular angles was greater in group A than in groups B and C (P < .05). The mean operative time did not differ among the 3 groups. CONCLUSIONS: CAD can guide mandibular angle remodeling and condyle placement. CAD and surgical navigation increase reconstruction accuracy without prolonging operative time.
PURPOSE: Although free fibula flaps are widely used for mandibular reconstruction, their 3-dimensional position is difficult to control during conventional surgery. We aimed to improve this process by using computer-aided design (CAD) and surgical navigation. PATIENTS AND METHODS: We retrospectively reviewed 29 benign tumorpatients who underwent primary unilateral mandibular reconstruction with free fibula flap. They were divided into 3 groups: group A, comprising 10 patients, underwent reconstruction based on the surgeon's experience; group B, comprising 7 patients, underwent reconstruction based on CAD; and group C, comprising 12 patients, underwent reconstruction based on CAD and surgical navigation. Condyle and gonion positions and mandibular angles were measured. Operative times were recorded. RESULTS: Among the 17 patients who underwent condylar resection, the average condyle shift was greater in group A than in groups B and C (P < .05). The average gonion shift was greater in groups A and B than in group C (P < .05). The difference between the reconstructed and contralateral mandibular angles was greater in group A than in groups B and C (P < .05). The mean operative time did not differ among the 3 groups. CONCLUSIONS: CAD can guide mandibular angle remodeling and condyle placement. CAD and surgical navigation increase reconstruction accuracy without prolonging operative time.
Authors: Simon Meyer; Jan-Michaél Hirsch; Christoph S Leiggener; Bilal Msallem; Guido R Sigron; Christoph Kunz; Florian M Thieringer Journal: J Clin Med Date: 2020-12-20 Impact factor: 4.241