Virtual Surgical Planning for Successful Second-Stage Mandibular Defect Reconstruction Using Vascularized Iliac Crest Bone Flap: A Valid and Reliable Method

PURPOSESecond-stage reconstruction of mandibular defects faces problems of anatomic disorder and bone displacement due to tumor resection. As a newer technique, virtual surgical planning (VSP) may help to increase the accuracy and efficiency of the complicated reconstruction. This study aims to eval...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Annals of plastic surgery 2020-02, Vol.84 (2), p.183-187
Hauptverfasser: Li, Yusang, Shao, Zhe, Zhu, Yuxi, Liu, Bing, Wu, Tianfu
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:PURPOSESecond-stage reconstruction of mandibular defects faces problems of anatomic disorder and bone displacement due to tumor resection. As a newer technique, virtual surgical planning (VSP) may help to increase the accuracy and efficiency of the complicated reconstruction. This study aims to evaluate the application of VSP and splint-guided surgery in second-stage mandibular reconstruction using vascularized iliac crest bone flap. METHODSBetween October 2016 and February 2018, 5 patients (3 men and 2 women) with mandibular defects of duration between 8 months and 8 years underwent VSP-aided secondary reconstruction in the School and Hospital of Stomatology of Wuhan University (Wuhan, China). Virtual surgical planning was performed and serial guiding splints were printed to replicate the design into the actual operation. The linear and 3-dimensional deviations after surgery were analyzed. Patient complications and feedback were recorded during follow up. RESULTSAll 5 patients underwent successful reconstruction using vascularized iliac crest bone flap. No serious donor sites or recipient site complications were observed after 10- to 28-month follow-up. In comparison with the presurgery designs, the linear deviations in coronal plane were 2.7 ± 0.4 mm (range, −2.2 to 3.9 mm) in measurements from the condylar head to the condylar head and 0.70 ± 0.6 mm (range, −0.1 to 1.7 mm) from the gonial angle to the gonial angle, and that in sagittal plane was 2.4 ± 0.88 mm (range, −3 to 4.4 mm) from the anterior inferior mandibular border to the center point on the condylar head to the condylar head line. The whole 3-dimensional deviation was 1.2 ± 1.7 mm in all patients. CONCLUSIONWell-designed splints can assist in precise mandibular reconstruction with high efficiency and accuracy, and thus are a reliable method for complicated second-stage mandibular reconstruction. However, to achieve a better outcome, a satisfactory design is required to adapt the complicated and varied defect.
ISSN:0148-7043
1536-3708
DOI:10.1097/SAP.0000000000002102