複雑な顎顔面欠損に対するコンピュータ支援設計/コンピュータ支援製造（CAD/CAM）誘導肩甲骨先端遊離皮弁再建
Francesco Laganà1, Alice Marzi Manfroni1, Francesco Arcuri1
1Maxillofacial Surgery Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Microsurgery
|January 10, 2026
まとめ
コンピュータ支援設計・製造（CAD/CAM）と肩甲骨先端遊離皮弁（STFF）は、複雑な顎顔面再建を改善します。この技術は、手術精度を高め、手術時間を短縮し、患者にとって予測可能な機能的および審美的転帰をもたらします。
科学分野:
- Oral and Maxillofacial Surgery
- Plastic Surgery
- Biomedical Engineering
背景:
- Reconstructing complex maxillary and mandibular defects after cancer surgery presents significant challenges.
- The scapular tip free flap (STFF) offers a viable solution due to its vascularity and bone stock.
- Computer-Aided Design and Manufacturing (CAD/CAM) can optimize reconstructive surgery, but its application in STFF for supine harvesting and inset is novel.
研究 の 目的:
- To evaluate the advantages of using CAD/CAM technology to guide resection and reconstruction in complex maxillary and mandibular defects using STFF.
- To assess the impact of CAD/CAM-assisted STFF on operative efficiency, functional recovery, and aesthetic outcomes.
主な方法:
- A retrospective analysis of nine patients who underwent maxillary or mandibular reconstruction with STFF between January 2023 and December 2024.
- Preoperative virtual surgical planning using CAD/CAM for patient-specific guides and plates.
- Assessment of functional outcomes (EORTC QLQ-HN35), morphological accuracy (3D imaging overlay), operative/ischemia times, complications, and patient satisfaction.
主要な成果:
- All reconstructions were successful with no major intraoperative complications.
- CAD/CAM planning facilitated precise osteotomies and flap contouring, reducing ischemia time and improving workflow, especially in mandibular cases.
- High concordance between pre- and postoperative imaging demonstrated satisfactory restoration of facial contour, with high patient satisfaction.
結論:
- CAD/CAM-assisted STFF reconstruction enables accurate 3D restoration, shortening operative and ischemia times.
- This approach leads to predictable functional recovery and favorable aesthetic results in complex maxillofacial defects.
- Despite increased planning, CAD/CAM enhances efficiency and reproducibility, offering a valuable option for selected patients.
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