Three-dimensional accuracy of virtual planning and surgical navigation for mandibular reconstruction with free fibula flap

Publication date: Available online 27 February 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Yao Yu, Wen-Bo Zhang, Xiao-Jing Liu, Chuan-Bin Guo, Guang-Yan Yu, Xin Peng
ObjectiveAlthough free fibula flaps are widely used for mandibular reconstruction, their three-dimensional position is difficult to control during conventional surgery. We aimed to improve this process by using computer-aided design (CAD) and surgical navigation.MethodsWe retrospectively reviewed 29 benign tumor patients who underwent primary unilateral mandibular reconstruction with free fibula flap. Patients were divided into three groups: group A, 10 patients, reconstruction based on surgeon's experience; group B, 7 patients, reconstruction based on CAD; and group C, 12 patients, reconstruction based on CAD and surgical navigation. Condyle and gonion positions and mandibular angles were measured. Operative times were recorded.ResultsIn the 17 patients who underwent condyle resection, the average condyle shift was greater in group A than in groups B and C (P < 0.05). The average gonion shift was greater in groups A and B than in group C (P < 0.05). The difference between the reconstructed and contralateral mandibular angle was greater in group A than in groups B and C (P < 0.05). Mean operative time did not differ between the three groups.ConclusionCAD can guide mandibular angle remodeling and condyle placement. CAD and surgical navigation increase reconstruction accuracy without prolonging operative time.



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