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Standardized Protocol for Virtual Surgical Plan and 3-Dimensional Surgical Template-Assisted Single-Stage Mandible
Xi Fu1, Jia Qiao, Sabine Girod
1From the *The Craniofacial Center One, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; and †Plastic and Reconstructive Surgery, Stanford, Palo Alto, CA.
Background:
Mandible contour surgery, including reduction gonioplasty and genioplasty, has become increasingly popular in East Asia. However, it is technically challenging and, hence, leads to a long learning curve and high complication rates and often needs secondary revisions. The increasing use of 3-dimensional (3D) technology makes accurate single-stage mandible contour surgery with minimum complication rates possible with a virtual surgical plan (VSP) and 3-D surgical templates. This study is to establish a standardized protocol for VSP and 3-D surgical templates-assisted mandible contour surgery and evaluate the accuracy of the protocol.
Methods:
In this study, we enrolled 20 patients for mandible contour surgery. Our protocol is to perform VSP based on 3-D computed tomography data. Then, design and 3-D print surgical templates based on preoperative VSP. The accuracy of the method was analyzed by 3-D comparison of VSP and postoperative results using detailed computer analysis.
Result:
All patients had symmetric, natural osteotomy lines and satisfactory facial ratios in a single-stage operation. The average relative error of VSP and postoperative result on the entire skull was 0.41 ± 0.13 mm. The average new left gonial error was 0.43 ± 0.77 mm. The average new right gonial error was 0.45 ± 0.69 mm. The average pognion error was 0.79 ± 1.21 mm. Patients were very satisfied with the aesthetic results. Surgeons were very satisfied with the performance of surgical templates to facilitate the operation.
Conclusions:
Our standardized protocol of VSP and 3-D printed surgical templates-assisted single-stage mandible contour surgery results in accurate, safe, and predictable outcome in a single stage.
