Accuracy of Fibula Reconstruction Using Patient-Specific Cad/Cam Plates: A Multicenter Study on 47 Patients

Laryngoscope. 2021 Jul;131(7):E2169-E2175. doi: 10.1002/lary.29379. Epub 2021 Jan 16.

Abstract

Objectives: This prospective study evaluated the accuracy of mandibular reconstruction using free fibular flaps (by comparing virtual plans to the three-dimensional postoperative results), and the extent of bone-to-bone contact after computer-assisted surgery.

Methods: We included 65 patients who underwent partial-continuity mandibular resections from February 2013 to January 2017, and evaluated virtual planning, surgical techniques, and accuracy.

Results: Forty-seven patients were analysed. A total of 112 fibular segments received 54 implants. We measured 227 distances between landmarks to assess the accuracy of reconstruction. Postoperative reconstruction accuracy ranged from 0.5 to 3 mm.

Conclusion: Virtual surgical planning very accurately translated simulation into reality, particularly in patients requiring large, complex mandibular reconstructions using multiple fibular segments.

Level of evidence: 4 Laryngoscope, 131:E2169-E2175, 2021.

Keywords: CAD/CAM; accuracy of reconstruction; fibula flap; mandibular reconstruction; reconstruction surgery.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Adult
  • Anatomic Landmarks / diagnostic imaging
  • Computer-Aided Design*
  • Female
  • Fibula / diagnostic imaging
  • Fibula / surgery
  • Free Tissue Flaps*
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Mandibular Reconstruction / methods*
  • Middle Aged
  • Patient Care Planning
  • Patient-Specific Modeling*
  • Prospective Studies
  • Surgery, Computer-Assisted / methods*