Christopher-Philipp Nobis1, Marco Rainer Kesting2, Klaus-Dietrich Wolff3, Gesche Frohwitter2, Andrea Rau2, Jochen Weitz3. 1. Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glueckstrasse 11, D-91054, Erlangen, Germany. christopher-philipp.nobis@uk-erlangen.de. 2. Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glueckstrasse 11, D-91054, Erlangen, Germany. 3. Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, D-81675, Munich, Germany.
Abstract
OBJECTIVES: Mandibular reconstruction after segmental mandibulectomy can be challenging without virtual surgical planning and osteotomy guides. The purpose of this study was to analyze anatomic parameters to facilitate the evaluation of ideal fibula wedge osteotomies to reconstruct the neomandibula in a simple and cost-effective manner without the need for preoperative virtual planning. MATERIALS AND METHODS: Computed tomography scans were acquired from randomly selected patients, and all images were obtained from routine clinical diagnostics, e.g., tumor staging, or preoperatively before reconstruction. Data was used to calculate stereolithographic models of the mandible for length and angle measurements. Statistical analysis was performed (p < 0.05). RESULTS: CT scans of 100 patients were analyzed: 39 were female and 61 were male patients, mean age was 59.08a. The mandibular arch angle proved to be constant with 241.07 ± 2.39°. The outside B-segment length was 80.05 ± 5.16 mm; the anterior S-segment length was 27.69 ± 3.16 mm. The angle of the mandibular arch showed differences in means (p = 0.004) between age groups, but effect was proved low. No relevant statistical significances were detected. CONCLUSIONS: The development of a mandible reconstruction template tool would benefit the majority of head and neck patients, which is due to a constant mandibular arch angle and symphysis segment length throughout the general patient population, allowing the mimicking of a harmonic mandibular arch with up to three fibula segments. CLINICAL RELEVANCE: The developed mandible reconstruction template tool can facilitate the fibula wedge osteotomies necessary for reconstruction of an ideal neomandibula providing a novel approach which is simple and cost-effective.
OBJECTIVES: Mandibular reconstruction after segmental mandibulectomy can be challenging without virtual surgical planning and osteotomy guides. The purpose of this study was to analyze anatomic parameters to facilitate the evaluation of ideal fibula wedge osteotomies to reconstruct the neomandibula in a simple and cost-effective manner without the need for preoperative virtual planning. MATERIALS AND METHODS: Computed tomography scans were acquired from randomly selected patients, and all images were obtained from routine clinical diagnostics, e.g., tumor staging, or preoperatively before reconstruction. Data was used to calculate stereolithographic models of the mandible for length and angle measurements. Statistical analysis was performed (p < 0.05). RESULTS: CT scans of 100 patients were analyzed: 39 were female and 61 were male patients, mean age was 59.08a. The mandibular arch angle proved to be constant with 241.07 ± 2.39°. The outside B-segment length was 80.05 ± 5.16 mm; the anterior S-segment length was 27.69 ± 3.16 mm. The angle of the mandibular arch showed differences in means (p = 0.004) between age groups, but effect was proved low. No relevant statistical significances were detected. CONCLUSIONS: The development of a mandible reconstruction template tool would benefit the majority of head and neck patients, which is due to a constant mandibular arch angle and symphysis segment length throughout the general patient population, allowing the mimicking of a harmonic mandibular arch with up to three fibula segments. CLINICAL RELEVANCE: The developed mandible reconstruction template tool can facilitate the fibula wedge osteotomies necessary for reconstruction of an ideal neomandibula providing a novel approach which is simple and cost-effective.
Entities:
Keywords:
Digital morphology analysis; Fibula osteotomy; Head and neck anatomy; Mandible reconstruction; Microvascular fibula transplant; Reconstructive surgery
Authors: Jan J Lang; Mirjam Bastian; Peter Foehr; Michael Seebach; Jochen Weitz; Constantin von Deimling; Benedikt J Schwaiger; Carina M Micheler; Nikolas J Wilhelm; Christian U Grosse; Marco Kesting; Rainer Burgkart Journal: PLoS One Date: 2021-06-08 Impact factor: 3.240