Korean J Otorhinolaryngol-Head Neck Surg.  2021 Mar;64(3):135-147. 10.3342/kjorl-hns.2020.00724.

The Judgement for Development of Virtual Surgical Planning and Three-Dimensional Bio-Printing for Superior Reconstruction of Mandibular Defect by Fibular Graft on Head-Neck Cancer

• Shuborna NS
• Bhattarai BP
• Chaiyasamut T
• Kiattavornchareon S
• Wongsirichat N

• KMID: 2513931
• DOI: http://doi.org/10.3342/kjorl-hns.2020.00724

Abstract

Oncological resection followed by reconstruction with a free fibular graft is still considered to be the gold standard treatment for functional and prosthetic rehabilitation of oral cancer patients. But this tedious traditional process is challenging for surgeons, as they have to deal with associated curve anatomy, surrounding innervations, and maintenance of functional and aesthetical acceptability. Such manual and operator’s skill dependent surgery can commonly demand a longer treatment duration; leading to an increased risk for prolonging the period of ischemia with increased morbidity, which frequently ends with an uncertain, unsatisfactory outcome. Technological advancements in the 20th and 21st centuries present a revolutionary improvement in the field of reconstructive surgery. Virtual surgical planning (VSP) and threedimensional (3D) bio-printing incorporating computer-aided design and computer-aided modeling is a promising tech in modern head and neck reconstruction. This recent innovation is more polished regarding initiation of patient-customized models, pre-bent plates, and osteotomy guides which further increase surgical precision, improve operative efficiency, ensure proper wound healing, shorten operative time, reduce operative cost, and decrease morbidities. This review focuses on the virtual surgical planning and 3D bio-printing technologies to evaluate their efficiency of qualitative and quantitative outcomes of resection and reconstruction of mandible in head-neck cancer using fibular graft.

Keyword

Computer-aided design and computer-aided modeling system; Fibula free graft; Mandibular reconstruction; Oral squamous cell carcinoma; Virtual surgical planning; 3D printing.