Flow-through sequentially linked free flaps in head and neck reconstruction

Advanced 3-D Biomodelling Technology for Complex Mandibular Reconstruction

“…These flaps were selected because of: their "bone stock" availability; the similarity of contour with the mandible; the relatively good and long vascular pedicle and the possibility to reconstruct oral mucosa and/or facial and cervical skin with a thin and pliable flap (Costa et al, 2011). The iliac crest free flaps were always transferred as osteomuscular flaps.…”

“…To explore their full potential is sometimes hard for the surgeon, specially when he is forced to mentally transform 2-D images into a 3-D scenery as the one he is faced within the surgical field (Zenha et al, 2011). Three-dimensional (3-D) imaging has been developed to narrow the communication gap between radiologist and surgeon.…”

“…It enables virtual planning and simulation of surgical procedures and the production of very accurate physical models of the patient's anatomy (Winder & Bibb, 2005& Robiony et al, 2007. It has been applied successfully in several medical fields (Zenha et al, 2011) with particularly interesting results in craniomaxillofacial surgery. We have a 8-year experience in using this technology in complex craniomaxillofacial defects (primary and secondary), with the great majority of the cases involving extensive mandibular defects.…”

“…In our opinion, in complex mandible reconstruction, 3-D biomodelling technology is particularly useful in: major secondary defects (oncological, osteoradionecrosis, trauma) with important distortion of craniofacial structure; congenital malformations and primary tumour surgery when the dimensions of the tumour have altered normal anatomy considerably or the resection involves an angled region (genius or angle of the mandible) (Zenha et al, 2011).…”

“…Manual measurements and calculations and "eye-match" techniques to evaluate symmetries are often applied in the operating theatre. (Zenha et al, 2011) …”