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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
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Virtual Surgical Planning in Condyle Reconstruction of Posterior Mandibulectomy Defects
Katherine C Benedict1, Ignacio Velasco Martinez2, Benjamin McIntyre1
1University of Mississippi Medical Center, Division of Plastic and Reconstructive Surgery, Jackson, Mississippi.
Eplasty
|March 13, 2024
Summary
Virtual surgical planning (VSP) and fibula free flaps enable successful reconstruction of ameloblastoma defects involving the mandibular condyle. This approach restores function and improves occlusion, with nerve repair aiding sensory recovery.
Area of Science:
- Oral and Maxillofacial Surgery
- Oncology
- Biomedical Engineering
Background:
- Ameloblastoma, a rare odontogenic tumor, often requires extensive resection, including the mandible and condyle, leading to functional deficits.
- Virtual surgical planning (VSP) is crucial for precise reconstruction of complex mandibular defects, especially with preoperative malocclusion.
- This study focuses on reconstructing posterior mandibulectomy defects involving condylar resection.
Observation:
- A retrospective review included 3 patients with giant ameloblastoma (>4 cm) necessitating ramus and condylar resection.
- Reconstruction utilized fibula free flaps and VSP-customized mandibular plates.
- Procedures involved shortening the reconstructed ramus, contouring the condyle, and performing inferior alveolar nerve repair.
Findings:
- All patients achieved successful mandibular reconstruction, preserving function and improving occlusion.
- Inferior alveolar nerve repair with allograft facilitated neurosensory recovery in the trigeminal nerve distribution for 2 out of 3 patients.
Implications:
- Giant ameloblastoma with condylar involvement can be effectively managed using fibula free flaps, VSP, and reconstruction plates.
- This combined technique ensures excellent restoration of occlusion and mandibular function.
- Integrating inferior alveolar nerve reconstruction enhances the potential for significant neurosensory recovery.
