Arch Plast Surg.  2014 Sep;41(5):584-587. 10.5999/aps.2014.41.5.584.

Computer Simulation Surgery for Mandibular Reconstruction Using a Fibular Osteotomy Guide

• Jeong WS
• Choi JW
• Choi SH

• KMID: 2267662
• DOI: http://doi.org/10.5999/aps.2014.41.5.584

Abstract

In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

Keyword

Surgery, plastic; Head and neck neoplasms; Mandibular reconstruction; Free tissue flaps; Computer simulation

MeSH Terms

Aged
Carcinoma, Squamous Cell
Computer Simulation*
Female
Free Tissue Flaps
Head and Neck Neoplasms
Humans
Mandible
Mandibular Nerve
Mandibular Reconstruction*
Osteotomy*
Surgery, Plastic