Short and long‐term outcomes of <scp>three‐dimensional</scp> printed surgical guides and virtual surgical planning versus conventional methods for fibula free flap reconstruction of the mandible: Decreased nonunion and complication rates

May, Matthew; Howe, Benjamin M.; O’Byrne, Thomas J.; Alexander, Amy E.; Morris, Jonathon M.; Moore, Eric J.; Kasperbauer, Jan L.; Janus, Jeffrey R.; Abel, Kathryn M. Van; Dickens, Hunter J.; Price, Daniel L.

doi:10.1002/hed.26688

Cited by 37 publications

(33 citation statements)

References 27 publications

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“…With the aim of improving reconstruction results and shortening the duration of the surgical procedure, computer‐assisted design and computer assisted manufacturing (CAD/CAM) was introduced in the field of mandibular reconstruction in the mid‐2000s 8,9 . Using 3D‐printed jigs and patient specific osteosynthesis plates, a virtual plan for resection and reconstruction can be transferred to the operating room 10–12 . However, inaccuracies in surgical conversion of the virtual plan have been reported, accounting for deviations in the spatial alignment of the bone graft and mandibular condyles 13 .…”

Section: Introductionmentioning

confidence: 99%

Analysis of the accuracy of computer‐assisted DCIA flap mandibular reconstruction applying a novel approach based on geometric morphometrics

et al. 2022

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Background: This study evaluated the accuracy of computer-assisted surgery (CAS)-driven DCIA (deep circumflex iliac artery) flap mandibular reconstruction by traditional morphometric methods and geometric morphometric methods (GMM).Methods: Reconstruction accuracy was evaluated by measuring distances and angles between bilateral anatomical landmarks. Additionally, the average length of displacements vectors between landmarks was computed to evaluate factors assumed to influence reconstruction accuracy. Principal component analysis (PCA) was applied to unveil main modes of dislocation.Results: High reconstruction accuracy could be demonstrated for a sample consisting of 26 patients. The effect of the number of segments and length of defect on reconstruction accuracy were close to the commonly used significance threshold (p = 0.062/0.060). PCA demonstrated displacement to result mainly from sagittal and transversal shifts.Conclusions: CAS is a viable approach to achieve high accuracy in mandibular reconstruction and GMM can facilitate the evaluation of factors influencing reconstruction accuracy and unveil main modes of dislocation in this context.

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Section: Introductionmentioning

confidence: 99%

Analysis of the accuracy of computer‐assisted DCIA flap mandibular reconstruction applying a novel approach based on geometric morphometrics

et al. 2022

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“…In particular, such measures could focus on free flaps that probably contribute most to prolonged TUA. Strategies such as pre‐resection estimation of defect size and orientation based on clinical and radiological measurements, three‐dimensionally printed models and virtual planning, 25 and overestimation of defect size and later trimming if necessary of the skin/soft tissue/bony components of the flap could facilitate simultaneous start of both the extirpative and flap harvest components, thereby significantly reducing TUA.…”

Section: Discussionmentioning

confidence: 99%

Predictors of surgical site infection and pneumonia following oral cavity tumor surgery

Karthik

Dhiwakar

2021

Head & Neck

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Background To identify risk factors for surgical site infection (SSI) and pneumonia following oral cavity tumor surgery. Methods Retrospective chart review of a consecutive series of patients undergoing oral cavity resection. Several clinicopathologic variables were tested for their association with SSI and pneumonia. Results Three hundred and forty‐four cases in 330 patients were included. Incidence of SSI and pneumonia was 67 (19.5%) and 38 (11%), respectively. On multivariate analysis, marginal mandibulectomy and segmental mandibulectomy were independent risk factors for SSI, whereas time under anesthesia (TUA) was an independent risk factor for pneumonia. Receiver operating characteristic curve identified 390 min as the cutoff above which pneumonia was predicted with a high degree of accuracy. Conclusions In oral cavity resections, mandibulectomy predisposes to SSI. Further, prolonged TUA (>390 min) is a powerful predictor for pneumonia. As it is a modifiable risk factor, reduction in TUA might correspondingly lower the incidence of postoperative pneumonia.

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“…While no technology can supplant experience, VSP has the potential to assist more novice surgeons in tackling the reconstructive challenge of complex craniofacial defects. Stranix et al [38] presented two solutions to not having a pre-operative CT scan for planning purposes: using a mirror-image reconstruction of the uninvolved side or using normative data in lieu of an intact contralateral side. Initial results with VSP-aided free flap reconstruction of the traumatized face have been encouraging.…”

Section: Virtual Surgical Planningmentioning

confidence: 99%

Free tissue reconstruction of massive facial trauma - review of the literature and considerations to implement aesthetic and functional outcome

Pang¹,

Cash²,

Futran³

2022

Plast Aesthet Res

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The surgical armamentarium for the treatment of massive facial trauma has undergone a dramatic shift from early management strategies. Although tenants of acute trauma management continue to prioritize airway management and cardiopulmonary support, improved functional outcomes are achievable with an emphasis on early definitive free tissue transfer. The use of workhorse donor flaps, such as the radial forearm, fibula, and latissimus, have become the standard of care. An emphasis is placed on the separation of cranial, sinonasal, and oral contents and restoration of form and function. Here, we also discuss the management of telecanthus, nasal defects, and microstomia - sequelae which represent unique challenges to the reconstructive surgeon. The ability to perform virtual surgical planning and facial transplantation will likely shape future paradigms and represent the need to perform ongoing research.

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Short and long‐term outcomes of three‐dimensional printed surgical guides and virtual surgical planning versus conventional methods for fibula free flap reconstruction of the mandible: Decreased nonunion and complication rates

Cited by 37 publications

References 27 publications

Analysis of the accuracy of computer‐assisted DCIA flap mandibular reconstruction applying a novel approach based on geometric morphometrics

Analysis of the accuracy of computer‐assisted DCIA flap mandibular reconstruction applying a novel approach based on geometric morphometrics

Predictors of surgical site infection and pneumonia following oral cavity tumor surgery

Free tissue reconstruction of massive facial trauma - review of the literature and considerations to implement aesthetic and functional outcome

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