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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
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Surgical Margins After Computer-Assisted Mandibular Reconstruction: A Retrospective Study
Erika Crosetti1, Giovanni Succo1,2, Bruno Battiston3
1Head Neck Oncology Unit, Candiolo Cancer Institute, Fondazione del Piemonte per - l'Oncologia-Istituto di Ricovero e Cura a Carattere Scientifico (FPO-IRCCS), Candiolo, Italy.
Frontiers in Oral Health
|January 31, 2022
Summary
Virtual surgical planning in head and neck surgery enhances mandibular reconstruction accuracy. This retrospective study found satisfactory oncological outcomes, though intraoperative adjustments may alter virtual plans.
Area of Science:
- Oral and Maxillofacial Surgery
- Oncologic Surgery
- Medical Technology
Background:
- Virtual surgical planning (VSP) is increasingly used in head and neck surgery.
- Its efficacy in mandibular reconstruction is well-established.
- VSP requires precise execution, as deviations can impact oncological safety.
Purpose of the Study:
- To retrospectively evaluate surgical margins in VSP-guided mandibular resection and reconstruction.
- To analyze strategies for minimizing positive/close margins.
- To assess reconstructive plan modifications based on intraoperative findings.
Main Methods:
- Retrospective analysis of 26 oral cavity malignancy cases.
- Computer-assisted mandibular resection/reconstruction using VSP.
- Evaluation of bone, periosteal, and peri-mandibular tissue involvement.
- Analysis of surgical margin status.
Main Results:
- No intraoperative or perioperative complications reported.
- 20 patients achieved accurate mandibular reconstruction with negative bone margins using fibular free flaps.
- All 6 patients with comorbidities also achieved negative bone margins.
- One case required intraoperative resection enlargement; another had positive soft tissue margins.
Conclusions:
- VSP for mandibular reconstruction yields satisfactory oncological radicality and precision.
- Functional benefits and reduced operating times are noted.
- Surgeons must anticipate intraoperative modifications that may override VSP.
- Further research is needed to fully elucidate VSP's role.
