Virtual Surgical Planning in Subscapular System Free Flap Reconstruction of Midface Defects

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Midface reconstruction presents significant challenges, including orbital support, skull base integrity, and dental rehabilitation.
• Subscapular system free flaps (SF) offer substantial bone stock and separate soft tissue components for complex reconstructions.

Purpose of the Study:

• To evaluate the impact of virtual surgical planning (VSP) on subscapular system free flap reconstruction of the midface.
• To assess VSP's effect on subsite reconstruction, bone segment contact, and anatomical positioning.

Main Methods:

• Retrospective cohort study comparing patients with and without VSP for midface SF reconstruction.
• Analysis of reconstructed subunits, bony segment contact, and anatomical positioning of bone segments.

Main Results:

• VSP cases showed significantly more reconstructed subunits (5.9 vs. 4.2) and successful bony contact (2.2 vs. 1.4).
• VSP resulted in a higher percentage of segments in anatomic position (100% vs. 71%) with minimal deviation (<1 cm in 82% of measurements).
• No flap losses were reported in either group.

Conclusions:

• Virtual surgical planning (VSP) enhances subscapular system free flap reconstruction for midface defects.
• VSP improves subunit reconstruction, bone segment contact, and anatomical accuracy, making it a valuable tool for complex cases.