caa a22 4500 606182950 CHVBK 20210128100818.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s00405-014-3078-3 doi (NATIONALLICENCE)springer-10.1007/s00405-014-3078-3 Step-by-step surgical technique for mandibular reconstruction with fibular free flap: application of digital technology in virtual surgical planning [Elektronische Daten] [G. Succo, M. Berrone, B. Battiston, P. Tos, F. Goia, P. Appendino, E. Crosetti] At present, mandibular reconstruction with a fibular free flap is the gold standard for functional and esthetic rehabilitation after oncological surgery. The purpose of this study was to describe the computer-assisted mandibular reconstruction procedure adopting the customized solution Synthes ProPlan CMF. The study reports five consecutive patients with benign or malignant disease requiring mandibular reconstruction using a microvascular fibular free flap, pre-operative virtual planning, construction of cutting guides and customized laser pre-bent titanium plates. The surgical technique is discussed in a step-by-step fashion. The average post-operative hospital stay was 18±3days. Ischemia time was recorded in all five cases, with an average of 75±8min. No problems were encountered in any surgical step and there were no major complications. Excellent precision of cutting guides and a good fit of pre-bent plates were found on both the mandible and fibula. There was excellent precision in bone to bone contact and position between mandible and fibula graft. Measurement data from the pre-operative and post-operative CT scans were compared. The average difference (Δ) between programed segment lengths and CT control segment lengths was 0.098±0.077cm. Microsurgical mandibular reconstruction using a virtual surgical planning yields significantly shorter ischemia times and allows more precise osteotomies. The technology is becoming increasingly recognized for its ability to optimize surgical outcomes and minimize operating time. Considering that the extent of resection can be wider than predicted, this results in safer modeling of the fibula only after frozen sections have demonstrated the radicality of resection. Springer-Verlag Berlin Heidelberg, 2014 Virtual surgery nationallicence Mandibular reconstruction nationallicence Fibular free flap nationallicence Oromandibular reconstruction nationallicence Succo G. Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy aut Berrone M. Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy aut Battiston B. Department of Orthopaedics and Traumatology, Città della Salute e della Scienza Hospital, Turin, Italy aut Tos P. Department of Orthopaedics and Traumatology, Città della Salute e della Scienza Hospital, Turin, Italy aut Goia F. Department of Dentistry, Mauriziano Hospital, Turin, Italy aut Appendino P. Department of Dentistry, Mauriziano Hospital, Turin, Italy aut Crosetti E. Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/6(2015-06-01), 1491-1501 0937-4477 272:6<1491 2015 272 405 https://doi.org/10.1007/s00405-014-3078-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-3078-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Succo G. Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy aut NATIONALLICENCE 700 1- Berrone M. Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy aut NATIONALLICENCE 700 1- Battiston B. Department of Orthopaedics and Traumatology, Città della Salute e della Scienza Hospital, Turin, Italy aut NATIONALLICENCE 700 1- Tos P. Department of Orthopaedics and Traumatology, Città della Salute e della Scienza Hospital, Turin, Italy aut NATIONALLICENCE 700 1- Goia F. Department of Dentistry, Mauriziano Hospital, Turin, Italy aut NATIONALLICENCE 700 1- Appendino P. Department of Dentistry, Mauriziano Hospital, Turin, Italy aut NATIONALLICENCE 700 1- Crosetti E. Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/6(2015-06-01), 1491-1501 0937-4477 272:6<1491 2015 272 405