STUDY ON ACCURACY OF VIRTUAL SURGICAL PLANNING IN FREE FIBULA MANDIBULAR RECONSTRUCTION BY USING SurgiCase SOFTWARE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YAN Guangqi ¹ , WANG Xue ² , TAN Xuexin ¹ , WANG Xukai ¹ , YANG Mingliang ¹ , LU Li ¹

1Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang Liaoning, 110002, P.R.China;;
2Department of Orthodontics, Stomatology Hospital of Shenyang. Corresponding author: WANG Xukai, E-mail: wangxukai757892@sina.com;

Corresponding author：

Keywords：

SurgiCase software; Mandibular defect; Free fibula flap; Three-dimensional spiral CT

DOI：

10.7507/1002-1892.20130218

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Objective To evaluate the directional significance of SurgiCase software in free fibula mandibular reconstruction. Methods Between September 2010 and March 2012, 10 patients with mandibular defect underwent free fibula mandibular reconstruction. There were 7 males and 3 females, with an age range of 19-43 years (mean, 27 years). The extent of lesions was 7 cm × 5 cm to 16 cm × 8 cm. In each case, three-dimensional spiral CT scan of the maxilla, mandible, and fibula was obtained before surgery. The CT data were imported into the SurgiCase software and the virtual surgery planning was performed. After that, the mandibular rapid prototyping was made according to customized design. The reconstruction surgery was then carried out using these preoperative data. During actual surgery, the extent of mandibular defect was from 6 cm × 3 cm to 16 cm × 5 cm; the length of fibula which was used to reconstruct mandible was 6-17 cm; and the area of flap was from 6 cm × 5 cm to 16 cm × 6 cm. Results Preoperative data could not be applied because the intraoperative size of tumor was larger than preoperative design in 1 case of mandibular ameloblastoma, and the fibula was shaped according to the actual osteotomy location; operations were performed successfully according to preoperative design in the other 9 patients. The operation time was 5-7 hours (mean, 6 hours). Primary healing of incision was obtained, without early complications. Ten patients were followed up 1 year. At last follow-up, 8 patients were satisfactory with the appearance and 2 patients complained with unsatisfied wide facial pattern. The panoramic radiograghs showed good bone healing. The range of mouth opening was 2.5-3.5 cm. Conclusion SurgiCase software can provide precise data for free fibula mandibular reconstruction during surgery. It can be applied widely in clinic.

Citation： YAN Guangqi,WANG Xue,TAN Xuexin,WANG Xukai,YANG Mingliang,LU Li. STUDY ON ACCURACY OF VIRTUAL SURGICAL PLANNING IN FREE FIBULA MANDIBULAR RECONSTRUCTION BY USING SurgiCase SOFTWARE. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(8): 1006-1009. doi: 10.7507/1002-1892.20130218 Copy

1.	张庆福, 吕春堂, 樊堂堂, 等. 计算机辅助个体化下颌骨缺损的功能性修复. 中国临床康复, 2005, 9(22): 10-12.
2.	Hidalgo DA. Fibula free flap: a new method of mandible reconstruction. Plast Reconstr Surg, 1989, 84(1): 71-79.
3.	赵继刚, 彭国光, 钟凡, 等. 血管化游离腓骨瓣在下颌骨重建中的应用. 广东牙病防治, 2011, 19(5): 265-267.
4.	孙坚, 沈毅, 李军, 等. 应用SimPlant 软件精确匹配与缺损外形吻合的髂骨肌瓣行下颌骨重建. 组织工程与重建外科杂志, 2009, 5(6): 318-321.
5.	黄栋, 何冬梅, 张善勇, 等. 计算机辅助颌骨整形术前计划研究进展. 中国实用口腔科杂志, 2011, 4(11): 689-692.
6.	黄静娜, 胡顺广, 魏远坚. 下颌骨缺损修复重建研究进展. 中国美容医学, 2009, 18(9): 1546-1548.
7.	周训银, 李研, 吴殿源, 等. 吻合血管的自体骨移植修复下颌骨缺损76例回顾分析. 中国口腔颌面外科杂志, 2003, 1(2): 120-123.
8.	Hidalgo DA, Disa JJ, Cordeiro PG, et al. A review of 716 consecutive free flaps for oncologic surgical defects: refinement in donor-site selection and technique. Plast Reconstr Surg, 1998, 102(3): 722-732.
9.	廖宗生, 庞芳河. 腓骨瓣修复下颌骨缺损的现状. 中国误诊学杂志, 2009, 9(28): 6817-6818.
10.	Bilkay U, Tokat C, Helvaci E, et al. Free fibula flap mandible reconstruction in benign mandibular lesions. J Craniofac Surg, 2004, 15(6): 1002-1009.
11.	Klesper B, Lazar F, Siessegger M, et al. Vertical distraction osteogenesis of fibula transplants for mandibular reconstruction—a preliminary study. J Craniomaxillofac Surg, 2002, 30(5): 280-285.
12.	Leiggener C, Messo E, Thor A, et al. A selective laser sintering guide for transferring a virtual plan to real time surgery in composite mandibular reconstruction with free fibula osseous flaps. Int J Oral Maxillofac Surg, 2009, 38(2): 187-192.
13.	Roser SM, Ramachandra S, Blair H, et al. The accuracy of virtual surgical planning in free fibula mandibular reconstruction: comparison of planned and final results. J Oral Maxillofac Surg, 2010, 68(11): 2824-2832.
14.	苏忠平, 何黎升, 商洪涛, 等. 人体下颌骨节段性缺失的三维有限元模型的建立. 中国美容医学, 2011, 20(12): 1891-1894.

1. 张庆福, 吕春堂, 樊堂堂, 等. 计算机辅助个体化下颌骨缺损的功能性修复. 中国临床康复, 2005, 9(22): 10-12.
2. Hidalgo DA. Fibula free flap: a new method of mandible reconstruction. Plast Reconstr Surg, 1989, 84(1): 71-79.
3. 赵继刚, 彭国光, 钟凡, 等. 血管化游离腓骨瓣在下颌骨重建中的应用. 广东牙病防治, 2011, 19(5): 265-267.
4. 孙坚, 沈毅, 李军, 等. 应用SimPlant 软件精确匹配与缺损外形吻合的髂骨肌瓣行下颌骨重建. 组织工程与重建外科杂志, 2009, 5(6): 318-321.
5. 黄栋, 何冬梅, 张善勇, 等. 计算机辅助颌骨整形术前计划研究进展. 中国实用口腔科杂志, 2011, 4(11): 689-692.
6. 黄静娜, 胡顺广, 魏远坚. 下颌骨缺损修复重建研究进展. 中国美容医学, 2009, 18(9): 1546-1548.
7. 周训银, 李研, 吴殿源, 等. 吻合血管的自体骨移植修复下颌骨缺损76例回顾分析. 中国口腔颌面外科杂志, 2003, 1(2): 120-123.
8. Hidalgo DA, Disa JJ, Cordeiro PG, et al. A review of 716 consecutive free flaps for oncologic surgical defects: refinement in donor-site selection and technique. Plast Reconstr Surg, 1998, 102(3): 722-732.
9. 廖宗生, 庞芳河. 腓骨瓣修复下颌骨缺损的现状. 中国误诊学杂志, 2009, 9(28): 6817-6818.
10. Bilkay U, Tokat C, Helvaci E, et al. Free fibula flap mandible reconstruction in benign mandibular lesions. J Craniofac Surg, 2004, 15(6): 1002-1009.
11. Klesper B, Lazar F, Siessegger M, et al. Vertical distraction osteogenesis of fibula transplants for mandibular reconstruction—a preliminary study. J Craniomaxillofac Surg, 2002, 30(5): 280-285.
12. Leiggener C, Messo E, Thor A, et al. A selective laser sintering guide for transferring a virtual plan to real time surgery in composite mandibular reconstruction with free fibula osseous flaps. Int J Oral Maxillofac Surg, 2009, 38(2): 187-192.
13. Roser SM, Ramachandra S, Blair H, et al. The accuracy of virtual surgical planning in free fibula mandibular reconstruction: comparison of planned and final results. J Oral Maxillofac Surg, 2010, 68(11): 2824-2832.
14. 苏忠平, 何黎升, 商洪涛, 等. 人体下颌骨节段性缺失的三维有限元模型的建立. 中国美容医学, 2011, 20(12): 1891-1894.

Chinese Journal of Reparative and Reconstructive Surgery

STUDY ON ACCURACY OF VIRTUAL SURGICAL PLANNING IN FREE FIBULA MANDIBULAR RECONSTRUCTION BY USING SurgiCase SOFTWARE

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