Virtual surgical planning and cone beam computed tomography in reconstruction of head and neck tumors – pilot study

Abstract

The aim of study was to prove that combination of visual surgical planning (VSP) together with cone beam computed tomography (CBCT) is an optimal technique in fibular free flap reconstructions after complex tumor resections in the head and neck region and that it results in better functional and aesthetic outcome. Subjects and methods: 6 patients (3 females, 3 males) with head and neck tumors were included in the study. The region concerned midface in 2 cases and mandible in 4 patients. On the basis of computed tomography of the head, fibular free flap (FFF) reconstruction was planned with the VSP technique. 3D-printed models were prepared. At the beginning of the operation and few minutes after the reconstruction an xCAT CBCT by XORAN was performed. Minor corrections of the angles of the reconstructed bony parts were made where needed. The time of the operation was assessed for each case. Functional and cosmetic results were evaluated in 1-year follow up. Results: The average time of operation was 6 hours 48 minutes, which was app.1hour 40 minutes less than standard reconstructive surgery. Functional recovery was achieved in all patients. Aesthetic result was unsatisfactory for 2 patients due to insufficient soft tissue masses of the FFF. Conclusions: The authors claim that intraoperative CBCT imaging, regardless the cost, improves accuracy of aesthetic outcome of the reconstructive surgeries based on VSP, especially in the region of midface and mandible. Further studies on larger amount of subjects are required.

A Rare Case of Front Mandible Orthokeratinized Odontogenic Cyst – Surgical Management with Preventive Rigid Osteosynthesis

“…Using 3D printing of bone model was though an affordable and helpful aid to choose and prebend the standard plate and for the planning of the surgery. 16–19 In this case, single fixation plate was planned for bone fixation. Nevertheless, an additional plate was used to support soft tissue.…”

Monitoring cone-beam CT radiation dose levels in a University Hospital

“…For all age groups, CBCT imaging was requested most frequently for surgical planning and follow-up. CBCT is widely applied for several maxillofacial surgical tasks, playing an important role in applications such asthe evaluation of anatomical structures adjacent to third molars, [26][27][28] 3D printing surgical guidance, 29 virtual reductions of complex jaw fractures, 30 intraoperative imaging of reconstructive surgery outcome in the region of the midface and the mandible, 31 radiographic diagnoses and prediction of canine impaction, 32 tooth segmentation and auto-transplantation planning, [33][34][35] and 3D planning for orthognathic surgery. 36,37 Besides, the second most frequent indication was pedodontics diagnosis and special dental care.…”

Using 3D Imaging to Preoperatively Plan Facelift Procedures for the Lower Third of the Face and Neck

“…These tools have been used for different goals in the field of reconstructive surgery, including assessment of the microvascular anatomy for microsurgical reconstructions, diagnosis, preoperative evaluation, virtual planning, modeling of body parts, 3D printing, intraoperative evaluation, and postoperative follow-up [16][17][18][19][20][21][22].…”