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Updated: May 29, 2026
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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Unexpected Modifications to Surgical Plans in Computer-assisted Mandibulectomy With Fibula Free-flap Reconstruction:
Hidenori Suzuki1, Sumitaka Hagiwara2, Shintaro Beppu2
1Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan; hi.suzuki@aichi-cc.jp.
Anticancer Research
|May 27, 2026
Summary
Computer-assisted surgery (CAS) for mandibular reconstruction is effective, even with modifications after planning. This study highlights the need for more data on out-of-house CAS for complex cases.
Area of Science:
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
- Medical Technology
Background:
- Computer-assisted surgery (CAS) is crucial for precise segmental mandibulectomy and fibula free-flap reconstruction in gingival cancer.
- Modifying mandibulectomy after CAS planning is challenging, leading to in-house system development at high-volume centers.
Purpose of the Study:
- To evaluate the feasibility of using an out-of-house CAS system for modified segmental mandibulectomy with fibula free-flap reconstruction.
- To report outcomes from a five-case series utilizing a non-proprietary CAS system.
Main Methods:
- A five-case series of modified segmental mandibulectomy with fibula free-flap reconstruction using an out-of-house CAS system.
- Analysis of fibula osteotomy modifications, intraoperative cutting guide adjustments, and custom plate utilization.
Main Results:
- Two cases required no fibula osteotomy modification, while three needed medial or lateral site modifications.
- Intraoperative cutting guide modifications were necessary in four cases.
- Planned custom plates were successfully used without alteration in all five cases.
Conclusions:
- Out-of-house CAS systems can be utilized for modified segmental mandibulectomy and fibula free-flap reconstruction.
- Accumulating data from out-of-house CAS cases is essential for advancing CAS in mandibular reconstruction.