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Computer-assisted versus traditional freehand technique in fibular free flap mandibular reconstruction: a morphological comparative study.
Journal article

Computer-assisted versus traditional freehand technique in fibular free flap mandibular reconstruction: a morphological comparative study.

  • De Maesschalck T Division of Otolaryngology, Department of Neuroscience, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland.
  • Courvoisier DS Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland.
  • Scolozzi P Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland. paolo.scolozzi@hcuge.ch.
  • 2016-08-10
Published in:
  • European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. - 2017
Fibular free flap
Mandibular reconstruction
Patient specific implants
Virtual surgical planning
Adult
Aged
Female
Fibula
Free Tissue Flaps
Humans
Male
Mandible
Mandibular Reconstruction
Middle Aged
Osteotomy
Patient Care Planning
Retrospective Studies
Software
Surgery, Computer-Assisted
Tomography, X-Ray Computed
English The purpose of the study was to compare the accuracy of computer-assisted surgery (CAS) and the traditional freehand technique for fibular free flap mandibular reconstruction as well as to evaluate the accuracy of the CAS planning. The medical records of 18 patients who underwent mandibular reconstruction with fibular free flap were reviewed. The CAS group (n = 7) benefited from virtual surgical planning and custom patient-specific plates and surgical cutting guides. The Control group (n = 11) was treated by conventional surgery. Morphometric comparison was done by calculating the differences in specific linear and angular parameters on pre- and postoperative CT-scans for both groups by using ProPlan CMF® software. Symmetry was also assessed by calculating the ratio of the affected versus the nonaffected side. In the CAS group, planned and postoperative CT-scans were compared to evaluate accuracy. The morphometric comparison showed no statistically significant differences between the groups except for the axial angle on the nonaffected side (mean difference 1.0° in the CAS group versus 2.9° in the Control group; p = 0.03). Ratios of the affected side over the nonaffected side showed no differences between the two groups. In the CAS group, the accuracy assessment showed a mean distance deviation of 2.3 mm for mandibular osteotomies and 1.9 mm for fibular osteotomies. Our results indicated that CAS and the conventional freehand techniques were comparable in their ability to provide a satisfactory morphological fibular free flap mandibular reconstruction. Moreover, the accuracy of the CAS technique was within the range reported in the literature.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/137850
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