Tingwei Bao1, Jianfeng He1, Changyang Yu2, Wenquan Zhao1, Yi Lin1, Huiming Wang1, Jianhua Liu1, Huiyong Zhu3. 1. Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. 2. 6D Dental Tech Co., Ltd, Hangzhou, China. 3. Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Electronic address: zhuhuiyong@zju.edu.cn.
Abstract
OBJECTIVES: We evaluated the effects of three-dimensional virtual planning and the use of a plate-embedded surgical guide in mandibular reconstruction with microvascular fibula flaps. MATERIALS AND METHODS: We retrospectively reviewed 35 patients who underwent primary mandibular reconstruction with a free fibula flap. They were divided into three groups according to the therapy they received. In group A, 12 patients underwent reconstruction using the modified surgical guide system, including virtual surgeries, pre-bent titanium plates, screw-predesignated cutting guides for mandibular and fibular osteotomies, and plate-embedded shaping guides. In group B, 14 patients underwent reconstruction using the common surgical guide system, including virtual surgeries, cutting guides and pre-bent plates. In group C, 9 patients underwent reconstruction based on the surgeon's experience. All cases were reviewed for the total operative time, ischemia time of the fibula flaps, accuracy of surgery, and postoperative complications. RESULTS: All of the fibula flaps survived. In group A, the ischemia time was shorter than that of groups B and C (P < .05). The average gonion and condyle shift was lower in group A than in groups B and C (P < .01). CONCLUSIONS: Application of the screw-predesignated and plate-embedded surgical guide system can reduce the ischemia time and operation time in mandibular reconstruction with a fibula flap, and can increase reconstruction accuracy. This method is a precise and highly reliable technique for improving the clinical outcome of mandibular reconstruction.
OBJECTIVES: We evaluated the effects of three-dimensional virtual planning and the use of a plate-embedded surgical guide in mandibular reconstruction with microvascular fibula flaps. MATERIALS AND METHODS: We retrospectively reviewed 35 patients who underwent primary mandibular reconstruction with a free fibula flap. They were divided into three groups according to the therapy they received. In group A, 12 patients underwent reconstruction using the modified surgical guide system, including virtual surgeries, pre-bent titanium plates, screw-predesignated cutting guides for mandibular and fibular osteotomies, and plate-embedded shaping guides. In group B, 14 patients underwent reconstruction using the common surgical guide system, including virtual surgeries, cutting guides and pre-bent plates. In group C, 9 patients underwent reconstruction based on the surgeon's experience. All cases were reviewed for the total operative time, ischemia time of the fibula flaps, accuracy of surgery, and postoperative complications. RESULTS: All of the fibula flaps survived. In group A, the ischemia time was shorter than that of groups B and C (P < .05). The average gonion and condyle shift was lower in group A than in groups B and C (P < .01). CONCLUSIONS: Application of the screw-predesignated and plate-embedded surgical guide system can reduce the ischemia time and operation time in mandibular reconstruction with a fibula flap, and can increase reconstruction accuracy. This method is a precise and highly reliable technique for improving the clinical outcome of mandibular reconstruction.
Authors: Wang-Yong Zhu; Wing Shan Choi; May Chun Mei Wong; Jingya Jane Pu; Wei-Fa Yang; Yu-Xiong Su Journal: Front Oncol Date: 2021-09-16 Impact factor: 6.244
Authors: Juan Pablo Rodríguez-Arias; Blanca Tapia; Marta María Pampín; Maria José Morán; Javier Gonzalez; Maria Barajas; Jose Luis Del Castillo; Carlos Navarro Cuéllar; Jose Luis Cebrian Journal: J Pers Med Date: 2022-06-07