Application of Intraoperative Navigation for the Reconstruction of Mandibular Defects With Microvascular Fibular Flaps-Preliminary Clinical Experiences

J Craniofac Surg. 2016 May;27(3):751-5. doi: 10.1097/SCS.0000000000002430.

Abstract

Background: A microvascular fibular flap is the main option for the reconstruction of mandibular defects. This paper introduces an innovative strategy for the accurate fabrication of fibular flaps.

Methods: Nine patients with mandibular tumors were included in this study. The mandibular reconstruction planning was performed using MIMICS 10.01. One reconstruction plate was preformed. During the operation, the fibular flap was fabricated and implanted using the BrainLab navigation system. Six to 12 months after surgery, computed tomography data were acquired and compared with preoperative planning.

Results: The osteotomy of the fibular flap and the mandible was easily performed, using the navigation and the osteotomy template respectively. The preformed plate accurately determined the position of the flap. The treatment outcome was consistent with the preoperative planning using 3D analysis.

Conclusions: Combination of the intraoperative navigation and preformed plate technique demonstrated great practical value in mandibular reconstruction with microvascular fibular flaps.

MeSH terms

  • Bone Plates
  • Bone Transplantation / methods*
  • Female
  • Fibula
  • Humans
  • Male
  • Mandible / surgery
  • Mandibular Neoplasms / surgery*
  • Mandibular Reconstruction / methods*
  • Microsurgery / methods
  • Middle Aged
  • Osteotomy / methods
  • Perforator Flap / surgery*
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / therapy
  • Surgery, Computer-Assisted / methods*
  • Tomography, X-Ray Computed