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Anatomical Landmark-guided Strategy for Computer-assisted Reconstruction of Infrastructure Maxillary Defects Using
Songying Wu1, Jingya Jane Pu1, Edmond Ho Nang Pow2
1From the Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Plastic and Reconstructive Surgery. Global Open
|March 25, 2025
Summary
A new strategy using anatomical landmarks for virtual surgical planning improves fibula flap reconstruction in head and neck cancer patients. This method enhances accuracy and outcomes in complex maxilla reconstructions.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic and Reconstructive Surgery
- Biomedical Engineering
Background:
- Computer-assisted surgery offers predictable outcomes in head and neck reconstruction.
- Optimal fibula bone segment arrangement for maxilla reconstruction remains a challenge.
- Current methods lack standardized approaches for virtual surgical planning in free fibula flap reconstructions.
Purpose of the Study:
- To introduce and validate a novel anatomical landmark-guided strategy for virtual surgical planning (VSP) of infrastructure maxilla reconstruction using free fibula flaps (FFFs).
- To assess the reproducibility and accuracy of this VSP strategy.
- To establish a quantitative method for analyzing postoperative outcomes in computer-assisted maxilla reconstruction.
Main Methods:
- A retrospective clinical study reviewed 20 patients undergoing computer-assisted infrastructure maxillectomy and FFF reconstruction.
- Anatomical landmarks and clinical parameters were assessed for reproducibility in VSP compared to preoperative maxilla.
- Postoperative outcomes were quantitatively analyzed by comparing the postoperative maxilla with the VSP model.
Main Results:
- The proposed anatomical landmark-guided strategy (Group A, 11 patients) showed a lower median landmark error (2.19 mm) in VSP compared to the preoperative maxilla than the modified approach (Group B, 9 patients) (4.54 mm).
- Group A demonstrated satisfactory recapture of the alveolar arch and maxillary width.
- The VSP strategy exhibited satisfactory reproducibility of quantitative metrics.
Conclusions:
- The anatomical landmark-guided strategy provides a validated and reproducible method for VSP in FFF reconstruction of the maxilla.
- This approach enables a structured quantitative analysis of postoperative results in computer-assisted maxilla reconstruction.
- The strategy enhances functional and aesthetic restoration in head and neck cancer patients requiring maxilla reconstruction.
