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Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template.

Melania Tatti1, Filippo Carta1, Mauro Bontempi1

  • 1Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy.

Journal of Personalized Medicine
|May 25, 2024
PubMed
Summary

Virtual surgical planning using 3D resin models improved aesthetic and functional outcomes for patients undergoing mandibular reconstruction after oral cancer surgery. This approach enhances symmetry and patient satisfaction compared to standard methods.

Keywords:
3D reconstructionfree flapmandibular reconstructionoral cancer

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Area of Science:

  • Oral and Maxillofacial Surgery
  • 3D Medical Modeling
  • Reconstructive Surgery

Background:

  • Oral cancer often necessitates segmental mandibulectomy.
  • Reconstruction typically involves fibula-free flaps.
  • Virtual surgical planning (VSP) with 3D models is an emerging technique.

Purpose of the Study:

  • To evaluate the impact of VSP using preoperative 3D resin models on aesthetic and functional outcomes.
  • To compare VSP with standard fibula-free flap reconstruction.
  • To assess patient satisfaction and objective reconstruction accuracy.

Main Methods:

  • Retrospective study of patients undergoing segmental mandibulectomy and fibula-free flap reconstruction (Jan 2021-Jan 2023).
  • Comparison between patients using a 3D template (VSP group) and those without (control group).
  • Qualitative (patient satisfaction, symmetry) and quantitative (pre- and postoperative CT comparison) analyses were performed.

Main Results:

  • Seven patients were included; all achieved symmetric mandibular contours.
  • 85.7% of patients reported aesthetic satisfaction.
  • Quantitative analysis showed improved accuracy in the VSP group regarding intercondylar distance, intergonial angle, and anteroposterior dimension.

Conclusions:

  • 3D-printed templates for mandibular reconstruction with microvascular fibula-free flaps enhance aesthetic outcomes.
  • VSP offers superior results compared to standard reconstruction approaches.
  • This technology improves patient-reported aesthetic satisfaction and objective surgical precision.