New approach for virtual surgical planning and mandibular reconstruction using a fibula free flap

Mottini, Matthias; Seyed Jafari, Seyed Morteza; Shafighi, Maziar; Schaller, Benoît (2016). New approach for virtual surgical planning and mandibular reconstruction using a fibula free flap. Oral oncology, 59, e6-e9. Elsevier 10.1016/j.oraloncology.2016.06.001

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Maxillofacial reconstruction poses a major challenge to surgeons because of the associated anatomical complexity, the sensitivity of the involved systems and the need to maintain a pleasing facial appearance. Here, we present a detailed description of a new method for extensive mandibular reconstruction using open-source virtual design software and a desktop 3D printer. A surgeon segmented preoperative computed tomography angiography scans with the Amira program to create a digital model of the mandible, skull and fibula. These datasets were imported into Blender, an open-source computer-aided design software package, where arrangement of the fibula segments into aligned sections was performed. Then, a desktop 3D printer was used to produce a reconstructed mandible. After fixation of a plate onto the reconstructed mandible, cutting guides were digitally designed using Blender. Following this, the surgeon performed mandible resection using the fixed cutting guides, which were 3D-printed using biocompatible plastic (Med 610/Stratasys Inc.) and fixed to the prebent reconstructed mandible at a predetermined position. After cutting the fibula with the help of the cutting guides and aligning the fibular segments into mandibular space, the surgeon fixed the segments to the reconstruction plate. Postoperatively, multislice computed tomography scans were taken for control purposes. Our method for mandibular reconstruction offers the following benefits: shorter operation planning time, increased accuracy during osteotomy through the use of a special fibula cutting guide and low costs. In brief, this method is an easy, precise and highly flexible technique for mandibular reconstruction with a fibula flap. Copyright © 2016 Elsevier Ltd. All rights reserved. KEYWORDS: Fibula free flap; Mandibular reconstruction; Virtual surgical planning

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Plastic, Reconstructive and Aesthetic Surgery
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Craniomaxillofacial Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Schädel-, Kiefer- und Gesichtschirurgie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Schädel-, Kiefer- und Gesichtschirurgie

UniBE Contributor:

Mottini, Matthias; Seyed Jafari, Seyed Morteza; Shafighi, Maziar and Schaller, Benoît

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1368-8375

Publisher:

Elsevier

Language:

English

Submitter:

Caroline Dominique Zürcher

Date Deposited:

17 May 2017 14:32

Last Modified:

20 Aug 2017 02:12

Publisher DOI:

10.1016/j.oraloncology.2016.06.001

PubMed ID:

27344375

Uncontrolled Keywords:

Fibula free flap; Mandibular reconstruction; Virtual surgical planning

BORIS DOI:

10.7892/boris.95124

URI:

https://boris.unibe.ch/id/eprint/95124

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