A computer-based comparative quantitative analysis of surgical outcome of mandibular reconstructions with free fibula microvascular flaps

Abstract

The free fibula osteoseptocutaneous flap is the standard for reconstruction of extensive mandibular defects. The procedure must be precise to achieve the required functional and aesthetic results. The aim of the present study was to calculate retrospectively the exact differences in surgical outcome based on preoperative and postoperative Computed Tomography data sets. Ten patients with unilateral reconstructions of the mandible with a fibula based on conventional planning were analyzed quantitatively, applying mirroring techniques with direct comparison of the theoretically optimum with the actual reconstruction. The results showed that there is a significant discrepancy between what is actually achieved and the theoretical optimum. The result of the present retrospective analysis shows that there is room for further improvement of the outcome in complex mandible reconstruction cases.

Key Words:

• Tumour
• flaps

Acknowledgements

Some of the data were presented at the Computer Assisted Radiology and Surgery (CARS) workshop 2009, Berlin, Germany, 27 June 2009. A minor part of the material in this paper has already been published, e.g. in the abstract booklet CARS: Reconstruction of the temporomandibular joint with free fibula microvascular flaps without and with surgical guides. Hirsch JM, Thor A, Leiggener C, Messo E, Acosta R, Krol Z, Buitrago-Telléz, Zeilhofer H-F. Int J of Computer Ass Radiol Surg 2009;4(Suppl 1):225–28.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.