Comparison between flat-panel volume computed tomography and histologic assessments of bone invasion of maxillofacial tumors: utility of an instantaneous radiologic diagnostic tool

Schaaf, Helmut; Wahab-Göthe, Takwa; Kerkmann, Heiko; Streckbein, Philipp; Obert, Martin; Pons-Kuehnemann, Joern; Ahrens, M.; Howaldt, Hans‐Peter; Attia, Sameh

doi:10.1016/j.oooo.2017.03.009

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…In this setting, there is also the best opportunity to find suitable vessels for the microanastomosis required for a fibular flap or any other microvascular flap. Frozen-section analysis and flat-panel volume computed tomography of the resected tissues ensure high reliability in terms of the complete removal of the tumor [ 13 ]. The immediate reconstruction of the complex soft-tissue and bone defects caused by the tumor ablative surgery requires free vascularized tissue transplant [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Donor-Site Morbidity after Fibula Transplantation in Head and Neck Tumor Patients: A Split-Leg Retrospective Study with Focus on Leg Stability and Quality of Life

Attia

Diefenbach

Schmermund

et al. 2020

Cancers

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The free fibula flap has been one of the most important microvascular grafts for orofacial reconstruction for more than 30 years. The complication rates at the donor-site reported in literature are considered to be low, but the published data vary greatly in some cases. In particular, restrictions in the stability and balance of the involved leg and their effects on the quality of life have been described very inconsistently to date. Therefore, this study mainly focuses on the stability and balance of the affected leg in a split-leg design. Between December 2014 and January 2018, out of 119 subjects who underwent mainly jaw ablative tumor surgery and reconstruction using a fibula flap, 68 subjects were examined for donor site morbidity. Besides reporting general types of complications, two specific test procedures were used. The Star Excursion Balance Test (SEBT) as a practical test for ankle function and the Foot and Ankle Disability Index (FADI) as a questionnaire in order to assess quality of life, depending on the lower leg function. SEBT revealed an average of 55.3 cm with the operated leg as the supporting leg, which corresponds to 95.5% of 57.9 cm achieved with the healthy leg as the supporting leg. An average FADI score of 89.4% was recorded. SEBT and FADI seem to be suitable methods of examination for subjects post fibular transplantation and pointed out minimal limitations of the involved legs in comparison to the unaffected legs. These limitations were clinically not relevant and they had minor influence on the subjects’ quality of life and their daily activities.

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Section: Introductionmentioning

confidence: 99%

Donor-Site Morbidity after Fibula Transplantation in Head and Neck Tumor Patients: A Split-Leg Retrospective Study with Focus on Leg Stability and Quality of Life

Attia

Diefenbach

Schmermund

et al. 2020

Cancers

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“…Possible changes in the resection margins have the consequence that in a two-team approach setting, the shaping of the neomandible must be stopped until the affected bone section has been evaluated. For intraoperative assessment of bony resection margins, flat-panel volume computed tomography could be used to increase tumor-free bony margins [ 72 ]. An ever-present risk is that a prepared PSI must be discarded if the bony resection margins change or unforeseen limitations occur on the soft tissue site.…”

Section: Discussionmentioning

confidence: 99%

Impact of Planning Method (Conventional versus Virtual) on Time to Therapy Initiation and Resection Margins: A Retrospective Analysis of 104 Immediate Jaw Reconstructions

Knitschke

Bäcker

Schmermund

et al. 2021

Cancers

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Virtual surgical planning (VSP) and patient-specific implants are currently increasing for immediate jaw reconstruction after ablative oncologic surgery. This technique contributes to more accurate and efficient preoperative planning and shorter operation time. The present retrospective, single-center study analyzes the influence of time delay caused by VSP vs. conventional (non-VSP) reconstruction planning on the soft and hard tissue resection margins for necessary oncologic safety. A total number of 104 cases of immediate jaw reconstruction with free fibula flap are included in the present study. The selected method of reconstruction (conventionally, non-VSP: n = 63; digitally, VSP: n = 41) are analyzed in detail. The study reveals a statistically significant (p = 0.008) prolonged time to therapy initiation with a median of 42 days when the VSP method compared with non-VSP (31.0 days) is used. VSP did not significantly affect bony or soft tissue resection margin status. Apart from this observation, no significant differences concerning local tumor recurrence, lymph node, and distant metastases rates are found according to the reconstruction method, and affect soft or bone tissue resection margins. Thus, we conclude that VSP for immediate jaw reconstruction is safe for oncological purposes.

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“…Flat-panel volume-computed tomography (fpVCT) allows for thorough, three-dimensional exploration of dental arches or human heads at a high resolution [17,18], which is superior to conventional CT systems [19][20][21][22]. It has already been shown that fpVCT is a suitable diagnostic tool for the detection of anatomical structures, such as lateral canals and pulp stones [22] .…”

Section: Introductionmentioning

confidence: 99%

Sensitivity of conventional radiographs and cone-beam computed tomography in detecting the remaining root-canal filling material

et al. 2020

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This study aimed to compare the sensitivity of radiographs and flat-panel volume-computed tomography (fpVCT) in detecting the remaining root-canal filling material. Thirty-two root canals in extracted human mandibular molars were prepared and obturated with gutta-percha and sealer. The filling material was removed, and the teeth were split longitudinally. Radiographs and fpVCT scans were obtained and digitized. Virtual images were developed using reconstruction software and then superimposed, and the remaining filling material was outlined. Direct observation of the split root halves using flatbed scans served as a control. The presence and extension of the remaining filling material were evaluated. Statistical analysis was conducted using chi-squared test (P < 0.05). A total of 116 remnants were detected in the flatbed scans, 81 in the fpVCT scans, and 90 in the radiographs, with no significant difference between the radiograph (78%) and fpVCT (70%) results (P = 0.18). In the fpVCT scans, 42% of the remnants exhibited the same dimensions as the control, whereas 27% appeared larger and 30% appeared smaller. In the radiographs, the dimensions of the remnants were identical to the control in 64% of cases, smaller in 29%, and larger in 7%. FpVCT did not exhibit better performance than dental radiographs in detecting the remaining root-canal-filling material: the extension of remnants was indicated correctly in the fpVCT in fewer than 50% of the samples.

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Comparison between flat-panel volume computed tomography and histologic assessments of bone invasion of maxillofacial tumors: utility of an instantaneous radiologic diagnostic tool

Cited by 4 publications

References 24 publications

Donor-Site Morbidity after Fibula Transplantation in Head and Neck Tumor Patients: A Split-Leg Retrospective Study with Focus on Leg Stability and Quality of Life

Donor-Site Morbidity after Fibula Transplantation in Head and Neck Tumor Patients: A Split-Leg Retrospective Study with Focus on Leg Stability and Quality of Life

Impact of Planning Method (Conventional versus Virtual) on Time to Therapy Initiation and Resection Margins: A Retrospective Analysis of 104 Immediate Jaw Reconstructions

Sensitivity of conventional radiographs and cone-beam computed tomography in detecting the remaining root-canal filling material

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