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Accuracy of Computer-Aided Design/Computer-Aided Manufacturing-Assisted Mandibular Reconstruction With a Fibula Free Flap

Geusens, Joris MD*; Sun, Yi MSc, PhD*; Luebbers, Heinz-Theo MD, DMD†,‡; Bila, Michel MD, DDS*; Darche, Vincent MD, DDS§; Politis, Constantinus MD, PhD*

doi: 10.1097/SCS.0000000000005704
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Background: The recent increase in computer-aided design and computer-aided manufacturing (CAD/CAM)-assisted surgery has warranted a thorough evaluation of the accuracy of virtual plan execution. Mandibular reconstructions with a fibula free flap were evaluated by comparing the fibular segments postoperatively with the virtual surgical plans.

Methods: This study included computed tomography data for 20 patients (11 males; mean age 61.3 years, range 47–74) that received a mandibular reconstruction with a fibula free flap. Linear distances (superior and inferior borders) of 41 fibula segments and intercoronoid distances were measured.

Results: The mean difference was 3.11 ± 2.80 mm for superior borders (range 0.02–12.20 mm), and 2.75 ± 2.61 mm for inferior borders (range 0.22–13.58 mm). The mean intercoronoid difference was 3.57 ± 1.80 mm (range 0.91–6.11 mm).

Conclusion: This study confirmed the presumed accuracy regarding the use of fibular and mandibular cutting guides. CAD/CAM is an attractive technique which enhances efficiency and assurance during surgery and preoperative planning.

*OMFS IMPATH research group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium

Surgical Planning Lab, Harvard Medical School, Brigham and Women's Hospital, Boston, MA

Clinic for Cranio-Maxillofacial Surgery, University Hospital of Zurich, Zurich, Switzerland

§Service de Chirurgie Orale et Maxillo-faciale CHR de Namur, Namur, Belgium.

Address correspondence and reprint requests to Yi Sun, MSc PhD, OMFS-IMPATH Research Group and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium; E-mail: yi.sun@uzleuven.be

Received 10 January, 2019

Accepted 6 May, 2019

The authors report no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcraniofacialsurgery.com).

© 2019 by Mutaz B. Habal, MD.