A Novel Fibula Osteotomy Guide for Mandibular Reconstruction

Xu, Liqun; Zhang, Chenping; Poh, Eugene Hze-Khoong; Yin, Xuelai; Shen, Shukun

doi:10.1097/prs.0b013e31824a9e55

Cited by 8 publications

(11 citation statements)

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“…Some studies have been performed in Asian patients so cephalometric measurements may differ from Westerners. 3,4 Second, the mandibular arch was reconstructed using three or four bone segments, whereas five segments are preferred at our institution. 3,4 The number of segments used to recreate the mandible parabola alters its overall shape and osteotomy angles.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Second, the mandibular arch was reconstructed using three or four bone segments, whereas five segments are preferred at our institution. 3,4 The number of segments used to recreate the mandible parabola alters its overall shape and osteotomy angles. While greater numbers of osteotomies is cited to increase the risk of segment ischemia, inclusion of a midbody osteotomy contributes significantly to the parabolic shape of the reconstructed mandible with a superior aesthetic result.…”

Section: Discussionmentioning

confidence: 99%

“…Third, the results of this study are based on measurements from hand drawn patient specific templates used in a consecutive series of mandible reconstruction, not from CT data. 3,4,6 Last, placement of osteotomy position may vary, particularly with surgeon experience, and can explain reported differences in angles. Over the last decade there has been an explosion in use of stereolithographic fabricated mandible and fibula cutting guides created with computer-aided design-computer-aided manufacturing (CAD-CAM) technology.…”

Section: Discussionmentioning

confidence: 99%

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Standardized Templates for Shaping the Fibula Free Flap in Mandible Reconstruction

Matros

Santamaría

Cordeiro

2013

J reconstr Microsurg

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Conversion of the straight fibula bone flap into the parabolic mandible shape can be performed using customized acrylic templates made from a 1:1 mandible computed tomography scan and lateral cephalogram. The premise of the current study is to objectively quantify the variability in a series of acrylic templates used for mandible reconstruction to assess the feasibility of creating a standardized template.In this study acrylic templates of 48 consecutive adult dentate patients who underwent fibula flap mandible reconstruction from 1994 to 1999 were evaluated. Osteotomy angles for the mandibular angle, midbody and parasymphysis, and length of each bony segment were determined using a metric ruler and protractor. Values were reported as means ± standard deviation.The mean mandibular angle measured 122.6 ± 6.4 degrees, while the midbody and parasymphysis angles were 153 ± 4.5 degrees and 130 ± 4.2 degrees, respectively. Mean bone segment lengths were: ramus 64.5 ± 9.8 mm, distal body 47.6 ± 4.2 mm, mesial body 40.6 ± 3.2 mm, and symphysis 18.5 ± 2.2 mm.It was concluded that the evaluation of patient acrylic templates used in a series of mandible reconstructions demonstrates osteotomy angles vary minimally (3-5%). Bone segment lengths vary from 10 to 15%, suggesting heterogeneity in mandible size. A standard template can be used to shape the fibula in most mandible reconstructions eliminating the need for routine preoperative imaging or costly fabricated computer-aided design/computer-aided manufacturing cutting guides.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Standardized Templates for Shaping the Fibula Free Flap in Mandible Reconstruction

Matros

Santamaría

Cordeiro

2013

J reconstr Microsurg

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“…The modelling process of the fibula flap has mostly been done by rule of thumb. Predesigned templates [7], pre-bent reconstruction plates [8,9] or osteotomy guides [10,11] are used to tailor the fibula. A method for reconstruction where the bone was sectioned with a prefabricated guide that also directs the insertion of dental implants was described by Rohner et al [12].…”

Section: Introductionmentioning

confidence: 99%

A computer-based comparative quantitative analysis of surgical outcome of mandibular reconstructions with free fibula microvascular flaps

Leiggener

Król

Gawelin

et al. 2014

Journal of Plastic Surgery and Hand Surgery

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The free fibula osteoseptocutaneous flap is the standard for reconstruction of extensive mandibular defects. The procedure must be precise to achieve the required functional and aesthetic results. The aim of the present study was to calculate retrospectively the exact differences in surgical outcome based on preoperative and postoperative Computed Tomography data sets. Ten patients with unilateral reconstructions of the mandible with a fibula based on conventional planning were analyzed quantitatively, applying mirroring techniques with direct comparison of the theoretically optimum with the actual reconstruction. The results showed that there is a significant discrepancy between what is actually achieved and the theoretical optimum. The result of the present retrospective analysis shows that there is room for further improvement of the outcome in complex mandible reconstruction cases.

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“…6 However, high-tech demand and cost may limit the popularity of CAD/CAM use in flap transfer. Xu et al 7 developed a novel fibula osteotomy guide for mandibular reconstruction according to the analysis of images of the jaw. However, it is used for the reconstruction of the anterior mandibular defects only.…”

mentioning

confidence: 99%

Chest tube template for free fibular flap osteotomies in mandibular reconstruction

Lin

Lee

2014

Microsurgery

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A Novel Fibula Osteotomy Guide for Mandibular Reconstruction

Cited by 8 publications

References 0 publications

Standardized Templates for Shaping the Fibula Free Flap in Mandible Reconstruction

Standardized Templates for Shaping the Fibula Free Flap in Mandible Reconstruction

A computer-based comparative quantitative analysis of surgical outcome of mandibular reconstructions with free fibula microvascular flaps

Chest tube template for free fibular flap osteotomies in mandibular reconstruction

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