Digital navigation and 3D model technology in mandibular reconstruction with fibular free flap: A comparative study - 05/12/20

Doi : 10.1016/j.jormas.2020.11.002

Youkang Ni ^a,^b , Xuedi Zhang ^c , Zhizhu Meng ^d , Zijia Li ^b , Siqi Li ^b , Zhong-fei Xu ^b , Changfu Sun ^b , Fayu Liu ^b,⁎ , Weiyi Duan ^b,⁎
^a Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, PR China
^b Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, PR China
^c Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, PR China
^d Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, PR China

^⁎Corresponding authors at: Address: No. 117 Nanjing North Street, Heping District, Shenyang, Liaoning 110002, PR China.Address: No. 117 Nanjing North Street, Heping DistrictShenyangLiaoning110002PR China

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Abstract

Objective

The low accuracy limits the use of fibular free flap (FFF). We apply digital navigation and 3D printing model technology in mandibular reconstruction to improve FFF’s accuracy.

Methods

34 patients who underwent with FFF to repair mandibular defects were divided into Navigation Group (13 cases, using digital navigation and 3D printing model) and Control Group (21 cases, only 3D printing model). We retrospectively reviewed patients’ hospitalization information and evaluated patients by subjective and objective items, such as UW-Qol scale, CT data.

Results

The operation time of Navigation Group was higher significantly than Control Group (10.36 ± 1.87vs9.00 ± 1.34 h).There were no significant differences in early postoperative complications. The Qol score of appearance, motion, anxiety were higher significantly in Navigation Group. The CT results showed that mandibular angle deviation and chin deflection of Navigation Group were better significantly than Control Group (1.72 ± 1.29° vs 3.69 ± 1.67°, 2.45 ± 1.39 vs 5.19 ± 2.13 mm).

Conclusions

The digital navigation can improve FFF’s accuracy in mandibular reconstruction. It doesn’t significantly increase complications. The digital navigation’s installation and operation methods should be simplified to shorter operation time and expand its application.

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Keywords : Digital navigation, 3D printing model technology, Mandibular reconstruction, Fibular free flap