Browse > Article
http://dx.doi.org/10.1186/s40902-015-0017-1

Preliminary clinic study on computer assisted mandibular reconstruction: the positive role of surgical navigation technique  

Huang, Jin-Wei (Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology)
Shan, Xiao-Feng (Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology)
Lu, Xu-Guang (Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology)
Cai, Zhi-Gang (Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology)
Publication Information
Maxillofacial Plastic and Reconstructive Surgery / v.37, no., 2015 , pp. 20.1-20.7 More about this Journal
Abstract
Background: The objectives of the present study were to investigate the reliability and outcomes of computer-assisted techniques in mandibular reconstruction with a fibula flap and verify whether the surgical navigation system was feasible in mandible reconstructive surgery. Methods: Eight cases were enrolled in the computer assisted surgery (CAS) group and 14 cases in the traditional group. The shaping and fixation of the fibula grafts were guided by computer assisted techniques, which could be monitored with the BrainLAB surgical navigation system. The variation of mandible configuration was evaluated by CT measurement in the Mimics software, including the variation of length, width, height and gonial angle of the mandible. The 3D facial soft tissue alteration was also analyzed in 3D chromatogram by Geomagic software. Results: All 22 fibula flaps survived. The mandibular configurations and facial contours had a better clinic result in the CAS group. The length, width, height and gonial angle of the reconstructive mandible were more similar to the original one. The Wilcoxon rank sum test analysis suggested significant differences in the measurements. The chromatographic analysis also visually showed superiority over the traditional group. Conclusions: The computer assisted surgical navigation method used in mandibular reconstruction is feasible and precise for clinical application. The contour of the reconstructed mandible and facial symmetry are improved with computer techniques.
Keywords
Computer assisted surgery; Mandibular defect; Fibula flap; Surgical navigation;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Rashid M, Tamimy MS, Ehtesham-Ul-Haq SSU, Rizvi ST (2012) Benign paediatric mandibular tumours: experience in reconstruction using vascularised fibula. J Plast Reconstr Aesthet Surg 65:325-31   DOI
2 Shan XF, Cai ZG, Zhang J, Zhang JG (2009) Bimaxillary reconstruction with vascularised and non-vascularised fibula. J Plast Reconstr Aesthet Surg 62:474-6   DOI
3 Punpale AS, Rajendra Prasad JS, Shetty KP, Kadam S, Udupa V (2006) An innovative design for simultaneous reconstruction of complexmaxillo-mandibular defects with single free fibula osteocutaneous flap. J Plast Reconstr Aesthet Surg 59:96-101   DOI
4 Nanjappa M, Natashekara M, Sendil Kumar C, Kumaraswamy SV, Keerthi R, Ashwin DP et al (2011) Transport distraction osteogenesis for reconstruction of mandibular defects": our experience. J Maxillofac Oral Surg 10:93-100   DOI
5 Noordhoek R, Pizer ME, Laskin DM (2012) Ameloblastic fibrosarcoma of the mandible: treatment, long-term follow-up, and subsequent reconstruction of a case. J Oral Maxillofac Surg 70:2930-5   DOI
6 Hanasono MM, Skoracki RJ (2013) Computer-assisted design and rapid prototype modeling in microvascular mandible reconstruction. Laryngoscope 123:597-604   DOI
7 Katsuragi Y, Kayano S, Akazawa S, Naqamatsu S, Koizumi T, Matsui T et al (2011) Mandible reconstruction using the calcium-sulphate three-dimensional model and rubber stick: a new method, 'mould technique', for more accurate, efficient and simplified fabrication. J Plast Reconstr Aesthet Surg 64:614-22   DOI
8 Tepper O, Hirsch D, Levine J, Garfein E (2012) The new age of three-dimensional virtual surgical planning in reconstructive plastic surgery. Plast Reconstr Surg 130:192-4   DOI
9 Zheng GS, Su YX, Liao GQ, Jiao PF, Liang LZ, Zhang SE et al (2012) Mandible reconstruction assisted by preoperative simulation and transferring templates: cadaveric study of accuracy. J Oral Maxillofac Surg 70:1480-5   DOI
10 Harsha G, Reddy SG, Talasila S, Salaam SA, Srinivasulu M, Reddy VS (2012) Mandibular reconstruction using AO/ASIF stainless steel reconstruction plate: a retrospective study of 36 cases. J Contemp Dent Pract 13:75-9
11 Yamanaka Y, Yajima H, Kirita T, Shimomura H, Tamaki S, Aoki K et al (2010) Mandibular reconstruction with vascularised fibular osteocutaneous flaps using prefabricated stereolithographic mandibular model. J Plast Reconstr Aesthet Surg 63:1751-3   DOI
12 Zheng GS, Su YX, Liao GQ, Chen ZF, Wang L, Jiao PF et al (2012) Mandible reconstruction assisted by preoperative virtual surgical simulation. Oral Surg Oral Med Oral Pathol Oral Radiol 113:604-11   DOI
13 Lopez-Arcas JM, Arias J, Del Castillo JL, Burgueno M, Navarrol I, Moran MJ et al (2010) The fibula osteomyocutaneous flap for mandible reconstruction: a 15-year experience. J Oral Maxillofac Surg 68:2377-84   DOI
14 Lin PY, Lin KC, Jeng SF (2011) Oromandibular reconstruction: the history, operative options and strategies, and our experience. ISRN Surg 2011:824251
15 SimonnEN MMA, Shubi FM, Kalyanyama BM, Stoelinga PJ (2006) Reconstruction of the mandible after ablative surgery for the treatment of aggressive, benign odontogenic tumours in Tanzania: a preliminary study. Int J Oral Maxillofac Surg 35:421-6   DOI
16 Khadka A, Hu J (2012) Autogenous grafts for condylar reconstruction in treatment of TMJ ankylosis: current concepts and considerations for the future. Int J Oral Maxillofac Surg 41:94-102   DOI
17 Wang G, Li J, Khadka A, Hsu Y, Li W, Hu J (2012) CAD/CAM and rapid prototyped titanium for reconstruction of ramus defect and condylar fracture caused by mandibular reduction. Oral Surg Oral Med Oral Pathol Oral Radiol 113:356-61   DOI
18 Hou JS, Chen M, Pan CB, Wang M, Wang JG, Zhang B et al (2012) Application of CAD/CAM-assisted technique with surgical treatment in reconstruction of the mandible. J Craniomaxillofac Surg 40:432-37   DOI
19 Sink J, Hamlar D, Kademani D, Khariwala SS (2012) Computer-aided stereolithography for presurgical planning in fibula free tissue reconstruction of the mandible. J Reconstr Microsurg 28:395-403
20 Ciocca L, Mazzoni S, Fantini M, Marchetti C, Scotti R (2012) The design and rapid prototyping of surgical guides and bone plates to support iliac free flaps for mandible reconstruction. Plast Reconstr Surg 129:859-61   DOI
21 Kalbermatten DF, Hauq M, Schaefer DJ, Wolfinger E, Schumacher R, Messmer P et al (2004) Computer aided designed neo-clavicle out of osteotomized free fibula: case report. Br J Plast Surg 57:668-72   DOI
22 Ueda K, Tajima S, Oba S, Omiya Y, Byun SI, Okada M (2001) Mandibular contour reconstruction with three-dimensional computer-assisted models. Ann Plast Surg 46:387-93   DOI
23 Lopes N, Oliveira DM, Vajgel A, Pita I, Bezerra T, Vasconcellos RJ (2009) A new approach for reconstruction of a severely atrophic mandible. J Oral Maxillofac Surg 67:2455-9   DOI
24 Vakharia KT, Natoli NB, Johnson TS (2012) Stereolithography-aided reconstruction of the mandible. Plast Reconstr Surg 129:194-5   DOI
25 Mahdian N, Dostalova T, Danek J, Nedoma J, Kohout J, Hubacek M et al (2013) 3D reconstruction of TMJ after resection of the cyst and the stress-strain analyses. Comput Methods Programs Biomed 110:279-289   DOI