Impact of 3D virtual planning on reconstruction of mandibular and maxillary surgical defects in head and neck oncology

Witjes, Max J. H.; Schepers, Rutger H.; Kraeima, Joep

doi:10.1097/moo.0000000000000437

Cited by 41 publications

(41 citation statements)

References 46 publications

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“…Nowadays, planning of surgical reconstruction starting with occlusion of teeth also safeguards a proper dental rehabilitation. This approach supports a thorough adjustment of the surgical and prosthetic planning and treatment before the oncologic treatment is started (Seikaly et al, 2019;Witjes et al, 2018). In a reconstruction meeting, the head and neck team can go through the available options of surgical, prosthetic or combined reconstruction.…”

Section: Multidisciplinary Approachmentioning

confidence: 78%

“…This 3D virtual model provides more insight into the implications and complexity of surgical and prosthetic rehabilitation. This insight allows the surgical team to analyse the surgical and rehabilitation outcome and plan the treatment (Kraeima et al., 2020; Witjes, Schepers, & Kraeima, 2018). Although intra‐oral scan techniques are widely used nowadays, some limitations can occur mostly due to poor intra‐oral access caused by, for example, the tumour, trismus or pain.…”

Section: Pretreatment Screeningmentioning

confidence: 99%

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Prosthodontic rehabilitation of head and neck cancer patients—Challenges and new developments

et al. 2020

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Section: Multidisciplinary Approachmentioning

confidence: 78%

Section: Pretreatment Screeningmentioning

confidence: 99%

Prosthodontic rehabilitation of head and neck cancer patients—Challenges and new developments

et al. 2020

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“…However, nausea, vertigo and headache have been reported with VR in 30-80% of the users, depending on the software [8,9]. VR surgical planning is gaining increasing attention since it has been shown to augment operative accuracy, efficiency and outcomes [10][11][12]. However, there are only very few independent studies, which investigate the validity and accuracy of VR in authentic settings [13].…”

Section: Electronic Supplementary Materialsmentioning

confidence: 99%

Virtual reality improves the accuracy of simulated preoperative planning in temporal bones: a feasibility and validation study

Timonen

Iso-Mustajärvi

Linder

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose Consumer-grade virtual reality (VR) has recently enabled various medical applications, but more evidence supporting their validity is needed. We investigated the accuracy of simulated surgical planning in a VR environment (VR) with temporal bones and compared it to conventional cross-sectional image viewing in picture archiving and communication system (PACS) interface. Methods Five experienced otologic surgeons measured significant anatomic structures and fiducials on five fresh-frozen cadaveric temporal bones in VR and cross-sectional viewing. Primary image data were acquired by computed tomography. In total, 275 anatomical landmark measurements and 250 measurements of the distance between fiducials were obtained with both methods. Distance measurements between the fiducials were confirmed by physical measurement obtained by Vernier caliper. The experts evaluated the subjective validity of both methods on a 5-point Likert scale qualitative survey. Results A strong correlation based on intraclass coefficient was found between the methods on both the anatomical (r > 0.900) and fiducial measurements (r > 0.916). Two-tailed paired t-test and Bland–Altman plots demonstrated high equivalences between the VR and cross-sectional viewing with mean differences of 1.9% (p = 0.396) and 0.472 mm (p = 0.065) for anatomical and fiducial measurements, respectively. Gross measurement errors due to the misidentification of fiducials occurred more frequently in the cross-sectional viewing. The mean face and content validity rating for VR were significantly better compared to cross-sectional viewing (total mean score 4.11 vs 3.39, p < 0.001). Conclusion Our study supports good accuracy and reliability of VR environment for simulated surgical planning in temporal bones compared to conventional cross-sectional visualization.

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“…In pathologies such as microtia, the healthy side can be three‐dimensionally imaged and mirrored, and a template can be prefabricated. In oncologic reconstruction, three‐dimensional planning based on a cone beam CT scan has been used successfully for mandible reconstruction and to a less extend for maxilla reconstruction (Weijs et al, 2016; Witjes, Schepers, & Kraeima, 2018; Zheng et al, 2013). For soft tissue excisions, however, the CT‐based planning is less reliable since most often there are no standardized incisions or tumor excision approaches.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of a template‐based anterolateral thigh flap for reconstruction of head and neck defects

et al. 2020

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Background: One of the challenges in head and neck reconstruction is to have an adequate understanding of the three-dimensionalities of the defects created after resections due to the high variability of clinical scenarios. Consequently, it is essential to design the flap to match the requirements of the defect in order to facilitate the insetting and to achieve a successful outcome. The anterolateral thigh flap (ALT) is a robust and versatile flap commonly used in head and neck reconstruction. In this study the authors use a handmade template as a tool to customize ALT flaps and its variations to fit more accurately the different shapes, volume, and components of the resulting defects. The aim of this study is to describe in detail this surgical approach and present the clinical experience in 100 consecutive cases using a template-based ALT flaps in head and neck reconstruction. Methods: A retrospective review was performed on all microvascular head and neck reconstruction cases between January 2013 and December 2017 in our institution where a template-based ALT flap design was performed. We describe in detail the surgical technique used and present the clinical outcomes. In addition, we analyzed the use of different designs of the ALT flaps including different flap components in relation to the location of the defect. Results: One hundred reconstructions for head and neck defects were performed in 97 patients. Seven types of ALT free flaps were performed: fasciocutaneous (46%), suprafascial (8%), adipofascial (9%), vastus lateralis muscle (3%), composite fasciocutaneous/adipofascial (9%), chimeric flaps (21%), and vascularized nerve grafts (4%). Oropharyngeal and periauricular defects were mostly reconstructed with fasciocutanoues design. In more complex three-dimensional defects such as skull base or midface defects, a chimeric flap was selected. In all cases the used of template facilitated the insetting of the free flap. The total flap loss was 2%. Conclusions: Customization of ALT flaps using intraoperative templates is a useful method for flap design which facilitates fitting of the flap to a variety of defects in head and neck reconstruction. Caroline Driessen and Naomi van Hout contributed equally to this study.

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Impact of 3D virtual planning on reconstruction of mandibular and maxillary surgical defects in head and neck oncology

Cited by 41 publications

References 46 publications

Prosthodontic rehabilitation of head and neck cancer patients—Challenges and new developments

Prosthodontic rehabilitation of head and neck cancer patients—Challenges and new developments

Virtual reality improves the accuracy of simulated preoperative planning in temporal bones: a feasibility and validation study

Usefulness of a template‐based anterolateral thigh flap for reconstruction of head and neck defects

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