Arch Craniofac Surg.  2017 Sep;18(3):149-154. 10.7181/acfs.2017.18.3.149.

The Pros and Cons of Computer-Aided Surgery for Segmental Mandibular Reconstruction after Oncological Surgery

Affiliations
  • 1Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 2Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. ps.jylee@catholic.ac.kr

Abstract

Computer-aided surgery (CAS) started being used for head and neck reconstruction in the late 2000s. Its use represented a paradigm shift, changing the concept of head and neck reconstruction as well as mandible reconstruction. Reconstruction using CAS proceeds through 4 phases: planning, modeling, surgery, and evaluation. Thus, it can overcome a number of trial-and-error issues which may occur in the operative field and reduce surgical time. However, if it is used for oncologic surgery, it is difficult to evaluate tumor margins during tumor surgery, thereby restricting pre-surgical planning. Therefore, it is dangerous to predetermine the resection margins during the pre-surgical phase and the variability of the resection margins must be taken into consideration. However, it allows for the preparation of a prebending plate and planning of an osteotomy site before an operation, which are of great help. If the current problems are resolved, its applications can be greatly extended.

Keyword

Computer-aided surgery; Mandible; Mandibular reconstruction; Resection margin; Microsurgical free flaps

MeSH Terms

Free Tissue Flaps
Head
Mandible
Mandibular Reconstruction*
Neck
Operative Time
Osteotomy
Surgery, Computer-Assisted*
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