Development of a novel resection and cutting guide for mandibular reconstruction using free fibula flap

Weitz, Jochen; Wolff, Klaus‐Dietrich; Kesting, Marco; Nobis, Christopher-Philipp

doi:10.1016/j.jcms.2018.09.007

Cited by 36 publications

(18 citation statements)

References 10 publications

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“…In this study, cutting guides showed promising results with no recurrence in all patients. This result is correlated with that reported in other studies (38)(39)(40) .…”

Section: Discussionsupporting

confidence: 93%

Computer guided algorithm for segmental mandibular resection and titanium plate reconstruction

Askar

Ali

2019

Egyptian Dental Journal

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Aim: The aim of this study was to introduce and assess a new computer guided algorithm using locating holes and cutting guides, for mandibular segmental resection in cases with massive contour deformity. Patients and Methods: This was a prospective study conducted on 6 consecutive cases with mandibular odontogenic neoplasms indicating lateral segmental mandibular resection. For all the patients, computer guided resection and titanium plate reconstruction using locating holes and cutting guides was performed. The patients were followed up for 6 months; and recurrence, appearance, occlusion, maximum incisal opening (MIO), midline shift, chewing, swallowing, speech, pain were recorded. Results: No recurrence occurred in the study till the end of follow up period. 33.3 % of the observed minor change in appearance, and 66.7 % observed no appearance change. No major disruption in occlusion occurred for any patient. The mean MIO was 41.8 ± 4.35 mm after 1 month, 42.3 ± 3.98 mm after 6 months, with no statistically significant difference. Chewing, swallowing, and speech were as normal for 5 patients (83.3 %). Conclusions: The computer guided resection and titanium plate reconstruction using locating holes and cutting guides was found to be beneficial with promising results regarding function and aesthetics, we recommend the use of this technique for initial resection and reconstruction in delayed grafting. Yet, its use as a definitive reconstruction should be subjected to longer follow up period studies.

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“…In this study, cutting guides showed promising results with no recurrence in all patients. This result is correlated with that reported in other studies (38)(39)(40) .…”

Section: Discussionsupporting

confidence: 93%

Computer guided algorithm for segmental mandibular resection and titanium plate reconstruction

Askar

Ali

2019

Egyptian Dental Journal

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“…The selected length for the anterior segment was estimated to be a safe segment length with regard to bone perfusion, as similar values have been used by the authors previously and throughout the literature without leading to complications [22][23][24]. Based on this data, the planned fibula free flap reconstruction templates could now be designed and constructed [25]. The developed fibula reconstruction tool can be both used on the patients' left and right fibulas without difference.…”

Section: Discussionmentioning

confidence: 94%

Development of a template tool for facilitating fibula osteotomy in reconstruction of mandibular defects by digital analysis of the human mandible

et al. 2020

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Objectives Mandibular reconstruction after segmental mandibulectomy can be challenging without virtual surgical planning and osteotomy guides. The purpose of this study was to analyze anatomic parameters to facilitate the evaluation of ideal fibula wedge osteotomies to reconstruct the neomandibula in a simple and cost-effective manner without the need for preoperative virtual planning. Materials and methods Computed tomography scans were acquired from randomly selected patients, and all images were obtained from routine clinical diagnostics, e.g., tumor staging, or preoperatively before reconstruction. Data was used to calculate stereolithographic models of the mandible for length and angle measurements. Statistical analysis was performed (p < 0.05). Results CT scans of 100 patients were analyzed: 39 were female and 61 were male patients, mean age was 59.08a. The mandibular arch angle proved to be constant with 241.07 ± 2.39°. The outside B-segment length was 80.05 ± 5.16 mm; the anterior S-segment length was 27.69 ± 3.16 mm. The angle of the mandibular arch showed differences in means (p = 0.004) between age groups, but effect was proved low. No relevant statistical significances were detected. Conclusions The development of a mandible reconstruction template tool would benefit the majority of head and neck patients, which is due to a constant mandibular arch angle and symphysis segment length throughout the general patient population, allowing the mimicking of a harmonic mandibular arch with up to three fibula segments. Clinical relevance The developed mandible reconstruction template tool can facilitate the fibula wedge osteotomies necessary for reconstruction of an ideal neomandibula providing a novel approach which is simple and cost-effective.

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“…Today, this option is the gold standard for mandibular reconstruction, including in our center. In particular, in extended bone and soft tissue resections, this flap can be modeled with multiple osteotomies and can provide bone, muscle, and skin for composite reconstruction [20] .…”

Section: Discussionmentioning

confidence: 99%

The use of free chimeric flaps in head and neck reconstruction: technical pearls and clinical applications

Tomasetti¹,

Kuttenberger²,

Meroni³

et al. 2021

PAR

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Aim: Head and neck region reconstructions are often delicate procedures that require different solutions at different layers. The use of chimeric flaps offers the interesting characteristic of combining different tissues, which is extremely valuable in this setting. In the present work, we share our experience with different types of conventional flaps, such as the radial flap, the medial sural artery perforator flap, and the fibula osteocutaneous flap. Methods: Over the last year, a series of five patients received advanced head and neck defects reconstruction employing chimeric flaps. The patients included two females and three males, with the mean age of 68-year-old. The defect was in four cases due to radical tumor resection in the oromandibular region. The fifth case was an osteoradionecrosis which needed a complete resection of the affected soft and bony tissue. Results: All five patients were successfully treated. Two of them received a chimeric free flap composed of multiple skin islands while the other three also comprised bone tissue transfer for mandible reconstruction. The mean follow-up period was ten months (range 3-8 months), and during this period neither postoperative complications nor signs of disease relapse were noted.

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Development of a novel resection and cutting guide for mandibular reconstruction using free fibula flap

Cited by 36 publications

References 10 publications

Computer guided algorithm for segmental mandibular resection and titanium plate reconstruction

Computer guided algorithm for segmental mandibular resection and titanium plate reconstruction

Development of a template tool for facilitating fibula osteotomy in reconstruction of mandibular defects by digital analysis of the human mandible

The use of free chimeric flaps in head and neck reconstruction: technical pearls and clinical applications

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