Accuracy of Computer-Aided Design/Computer-Aided Manufacturing-Assisted Mandibular Reconstruction With a Fibula Free Flap

J Craniofac Surg. 2019 Nov-Dec;30(8):2319-2323. doi: 10.1097/SCS.0000000000005704.

Abstract

Background: The recent increase in computer-aided design and computer-aided manufacturing (CAD/CAM)-assisted surgery has warranted a thorough evaluation of the accuracy of virtual plan execution. Mandibular reconstructions with a fibula free flap were evaluated by comparing the fibular segments postoperatively with the virtual surgical plans.

Methods: This study included computed tomography data for 20 patients (11 males; mean age 61.3 years, range 47-74) that received a mandibular reconstruction with a fibula free flap. Linear distances (superior and inferior borders) of 41 fibula segments and intercoronoid distances were measured.

Results: The mean difference was 3.11 ± 2.80 mm for superior borders (range 0.02-12.20 mm), and 2.75 ± 2.61 mm for inferior borders (range 0.22-13.58 mm). The mean intercoronoid difference was 3.57 ± 1.80 mm (range 0.91-6.11 mm).

Conclusion: This study confirmed the presumed accuracy regarding the use of fibular and mandibular cutting guides. CAD/CAM is an attractive technique which enhances efficiency and assurance during surgery and preoperative planning.

MeSH terms

  • Aged
  • Computer-Aided Design
  • Female
  • Fibula / surgery*
  • Free Tissue Flaps*
  • Humans
  • Male
  • Mandible / surgery
  • Mandibular Reconstruction*
  • Middle Aged
  • Plastic Surgery Procedures
  • Surgery, Computer-Assisted / methods
  • Tomography, X-Ray Computed