Long-Term Operative Outcomes of Preoperative Computed Tomography–Guided Virtual Surgical Planning for Osteocutaneous Free Flap Mandible Reconstruction

Chang, Eric I.; Jenkins, Matthew P.; Patel, Sameer A.; Topham, Neal S.

doi:10.1097/01.prs.0000475796.61855.a7

Cited by 127 publications

(113 citation statements)

References 19 publications

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“…In recent years, computer‐assisted surgery (CAS) has been recognized as a valuable method to support FFF mandibular reconstruction . Nowadays, the most popular CAS technique is computer‐aided design and manufacturing (CAD/CAM).…”

Section: Introductionmentioning

confidence: 99%

“…In this method, a virtual surgery plan (VSP) is developed, and then patient‐specific osteotomy guides are manufactured according to the VSP. Using the guides, the surgeon can harvest the FFF with predefined shape and dimensions . Whereas some studies demonstrated that use of the guides contributed to greater accuracy of the reconstruction procedures and shorter operating time, the influence of this technique on the overall treatment cost is still a matter of debate …”

Section: Introductionmentioning

confidence: 99%

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Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study

et al. 2019

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Objective: To analyze a novel navigation system utilizing augmented reality (AR) as a supporting method for fibula free flap (FFF) harvest and fabrication.Methods: A total of 126 simulated osteotomies supported with a cutting guide or one of two AR-based intraoperative navigation modules-simple AR (sAR) or navigated AR (nAR)-were carried out on 18 identical models of the fibula (42 osteotomies per method). After fusing postoperative computed tomography scans of the operated fibulas with the virtual surgical plan based on preoperative images, the objective outcomes-angular deviations from the planned osteotomy trajectory ( o ) and deviations of control points marked on the trajectory (mm)-were determined.Results: All analyzed methods provided similar accuracy of assisted osteotomies. The only significant difference referred to angular deviation in the sagittal plane, which was smaller after the cutting guide-assisted procedures than after the application of sAR and nAR (4.1 AE 2.29 vs. 5.08 AE 3.64 degrees, P = 0.031 and 4.1 AE 2.29 vs. 4.97 AE 2.91, P = 0.002, respectively). Mean deviation of control points after the cutting guide-assisted procedures was 2.76 AE 1.06 mm, as compared with 2.67 AE 1.09 mm for sAR and 2.95 AE 1.11 mm for nAR.Conclusion: Our study demonstrated that both novel AR-based methods provided similar accuracy of assisted harvesting and contouring of the FFF as the cutting guides. This fact, as well as the acceptability of the concept by clinicians, justify their further development and evaluation in preclinical settings.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study

et al. 2019

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“…The advent of preoperative virtual surgical planning with 3D RP model and simulation surgery before operation has resulted in more efficient and less traumatic and fast surgery (15). When ischemic time has been reduced below one hour, success rate of free flap is increased dramatically.…”

Section: Discussionmentioning

confidence: 99%

“…Titanium reconstruction plate (R-plate) is rigid and easy to apply in the segmental mandibular bone defect (15,16). There are controversies about miniplates application vs R-plate insertion during fibular free flap reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Mandibular Reconstruction using Simulation Surgery after Segmental Mandibulectomy

Hwang¹,

Kim²,

Ahn³

2016

Journal of International Society for Simulation Surgery

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Functional and esthetic reconstruction after segmental mandibulectomy is one of the most challenging surgeries in microsurgical reconstruction field. Simulation surgery before free flap reconstruction has been performed for efficient surgery and successful results. Fibula free flap is the flap of the choice for reconstruction of the segmental mandibular defect. Straight nature of the fibula bone requires multiple segmentations to fit into mandible. 3D rapid prototype (RP) model gives a lot of information for mandibular reconstruction. The purpose of this study was to report mandibular reconstruction with free fibular flap using simulation surgery. A total of 30 consecutive patients were included for functional and esthetic evaluation. Among 30 patients, two flaps showed necrosis after radiotherapy. The other flaps were all survived and showed successful reconstruction in both function and esthetics.Key WordsZZ3D RP ㆍSimulation surgery ㆍFibula free flap ㆍMandibular reconstruction.

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“…3 CASS involves three phases: planning the resection and osteotomies using threedimensional (3D) images based on computed tomography scans, subsequent modeling and 3D printing of the craniofacial skeleton, cutting guides, and reconstruction plate template, and executing the operation. 4 Previous studies have demonstrated the benefits of CASS in head and neck reconstruction, [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] including its improved precision 9,12,[17][18][19][20] and comparable or superior functional outcomes with decreased operative times. 6,17,18 A major criticism of CASS has been its cost.…”

mentioning

confidence: 99%

Computer-Aided Surgical Simulation in Head and Neck Reconstruction: A Cost Comparison among Traditional, In-House, and Commercial Options

Copeland-Halperin

Kaminsky

et al. 2018

J reconstr Microsurg

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Long-Term Operative Outcomes of Preoperative Computed Tomography–Guided Virtual Surgical Planning for Osteocutaneous Free Flap Mandible Reconstruction

Abstract: Therapeutic, III.

Cited by 127 publications

References 19 publications

Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study

Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study

Mandibular Reconstruction using Simulation Surgery after Segmental Mandibulectomy

Computer-Aided Surgical Simulation in Head and Neck Reconstruction: A Cost Comparison among Traditional, In-House, and Commercial Options

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