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Computer-assisted design and rapid prototype modeling in microvascular mandible reconstruction.

Matthew M Hanasono1, Roman J Skoracki

  • 1Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. mhanasono@mdanderson.org

The Laryngoscope
|September 26, 2012
PubMed
Summary

Computer-assisted design and rapid prototype modeling significantly enhance mandibular reconstruction speed and accuracy. These technologies are especially beneficial for complex cases involving distorted or destroyed mandibular anatomy.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Mandibular reconstruction presents challenges in achieving accurate and timely restoration of complex anatomy.
  • Traditional methods of plate bending can be imprecise, especially in cases with significant bone loss or distortion.

Purpose of the Study:

  • To evaluate the efficacy of computer-assisted design (CAD) and rapid prototype (RP) modeling in improving the speed and accuracy of mandibular reconstruction.
  • To assess the utility of CAD/RP modeling in complex reconstructive scenarios.

Main Methods:

  • A case-control study involving 38 subjects undergoing fibula free flap mandibular reconstruction using CAD and RP models.
  • Preoperative planning included CAD for virtual reconstruction and RP models for pre-bending titanium plates and creating cutting guides.
  • A control group received defect-matched reconstruction without CAD/RP assistance.

Main Results:

  • Mean operative time was reduced in the CAD/RP group (8.8 hours) compared to the control group (10.5 hours) (P = .0006).
  • CAD/RP group showed significantly less deviation in bony landmark positioning (4.11 mm vs. 6.92 mm) (P = .001).
  • Postoperative deviations from planned fibular segment lengths and angles were minimal (2.40 mm and 3.51°).

Conclusions:

  • CAD and RP modeling significantly improve the speed and accuracy of mandibular reconstruction.
  • These technologies are particularly advantageous in complex cases with distorted or destroyed mandibular architecture, such as those resulting from tumors, fractures, or prior resections.