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Related Experiment Video

Updated: Nov 6, 2025

A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible

A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible

Published on: January 28, 2020

Maxillectomy defects: Virtually comparing fibular and scapular free flap reconstructions.

Sally Nguyen¹, Khanh Linh Tran¹, Edward Wang¹

¹Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.

|May 7, 2021

Summary

Patient-specific fibular and scapular reconstructions offer distinct advantages for maxillectomy defects. Virtual analysis guides reconstruction choice based on defect type and patient goals.

Keywords:

free flap head and neck cancer microvascular reconstruction osseous flap virtual planning

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Last Updated: Nov 6, 2025

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Area of Science:

Oral and Maxillofacial Surgery
Plastic and Reconstructive Surgery
Biomedical Engineering

Background:

Maxillectomy defects present complex reconstructive challenges.
Patient-specific fibular and scapular free flaps are utilized in reconstruction.
Virtual surgical planning aids in optimizing reconstructive outcomes.

Purpose of the Study:

To virtually compare patient-specific fibular and scapular reconstructions for maxillectomy defects.
To evaluate reconstructions based on midface cephalometrics, dental implantability, and pedicle length.
To guide reconstructive strategy based on defect characteristics.

Main Methods:

Virtual creation of nine maxillectomy defects on ten maxillas.
Virtual reconstruction using patient-specific fibulas and scapulas.
Comparison of reconstructions for cephalometric restoration, dental implant placement, and pedicle length.

Main Results:

Vertically oriented scapula improved orbital floor and maxillary height (p<0.001) but reduced dental implantability (p<0.001) compared to fibula.
Fibula provided better maxillary projection in midline-crossing defects due to more osteotomy options.
Scapula and fibula reconstructions were suitable for dental implants with comparable pedicle lengths, favoring scapula in extensive defects.

Conclusions:

Fibular and scapular reconstructions offer unique benefits for maxillectomy defects.
The choice between fibula and scapula depends on specific defect morphology and reconstruction goals.
Virtual analysis facilitates goal-oriented, patient-specific reconstructive planning.