Digital navigation and 3D model technology in mandibular reconstruction with fibular free flap: A comparative study

Youkang Ni; Xuedi Zhang; Zhizhu Meng; Zijia Li; Siqi Li; Zhong-Fei Xu; Changfu Sun; Fayu Liu; Weiyi Duan

doi:10.1016/j.jormas.2020.11.002

Digital navigation and 3D model technology in mandibular reconstruction with fibular free flap: A comparative study

J Stomatol Oral Maxillofac Surg. 2021 Sep;122(4):e59-e64. doi: 10.1016/j.jormas.2020.11.002. Epub 2020 Nov 24.

Authors

Youkang Ni¹, Xuedi Zhang², Zhizhu Meng³, Zijia Li⁴, Siqi Li⁵, Zhong-Fei Xu⁶, Changfu Sun⁷, Fayu Liu⁸, Weiyi Duan⁹

Affiliations

¹ Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, PR China; Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, PR China. Electronic address: 1519086@zju.edu.cn.
² Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, PR China. Electronic address: 1520016@zju.edu.cn.
³ Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, PR China. Electronic address: 1085226208@qq.com.
⁴ Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, PR China. Electronic address: 1179492794@qq.com.
⁵ Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, PR China. Electronic address: 2730948025@qq.com.
⁶ Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, PR China. Electronic address: xzf7090@hotmail.com.
⁷ Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, PR China. Electronic address: changfusun@hotmail.com.
⁸ Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, PR China. Electronic address: lfyhjk@126.com.
⁹ Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, PR China. Electronic address: duanwy2013@163.com.

PMID: 33242657
DOI: 10.1016/j.jormas.2020.11.002

Abstract

Objective: The low accuracy limits the use of fibular free flap (FFF). We apply digital navigation and 3D printing model technology in mandibular reconstruction to improve FFF's accuracy.

Methods: 34 patients who underwent with FFF to repair mandibular defects were divided into Navigation Group (13 cases, using digital navigation and 3D printing model) and Control Group (21 cases, only 3D printing model). We retrospectively reviewed patients' hospitalization information and evaluated patients by subjective and objective items, such as UW-Qol scale, CT data.

Results: The operation time of Navigation Group was higher significantly than Control Group (10.36 ± 1.87vs9.00 ± 1.34 h).There were no significant differences in early postoperative complications. The Qol score of appearance, motion, anxiety were higher significantly in Navigation Group. The CT results showed that mandibular angle deviation and chin deflection of Navigation Group were better significantly than Control Group (1.72 ± 1.29° vs 3.69 ± 1.67°, 2.45 ± 1.39 vs 5.19 ± 2.13 mm).

Conclusions: The digital navigation can improve FFF's accuracy in mandibular reconstruction. It doesn't significantly increase complications. The digital navigation's installation and operation methods should be simplified to shorter operation time and expand its application.

Keywords: 3D printing model technology; Digital navigation; Fibular free flap; Mandibular reconstruction.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Fibula / surgery
Free Tissue Flaps*
Humans
Mandibular Reconstruction*
Printing, Three-Dimensional
Retrospective Studies