Journal of Prevention and Treatment for Stomatological Diseases ›› 2018, Vol. 26 ›› Issue (1): 2-8.doi: 10.12016/j.issn.2096-1456.2018.01.002

• Orginal Article • Previous Articles     Next Articles

Using virtual surgical planning for resection of jaw tumor and accurate reconstruction

Jian SUN(), Yi SHEN()   

  1. Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
  • Received:2017-09-15 Revised:2017-10-12 Published:2018-08-31

Abstract:

Objective To review the patients who underwent accurate maxillary and mandibular reconstruction with vascularized osteomyocutaneous flap using virtual surgery and evaluate the postoperative results. Methods From June of 2009 to December of 2014, ninety-four patients were treated in our department. In virtual surgical planning, maxillectomy and mandibulectomy were simulated and donor site bone was superimposed mirror image of normal maxilla and mandible to complete accurate maxillary and mandibular reconstruction. Maxillectomy, mandibulectomy and bone reconstruction were performed using stereomodels and guided templates to replicate the virtual planning. Actual reconstruction result was compared with that of virtual surgery. The patients were asked to assess their satisfaction with facial appearance at 1 year postoperatively. Results Good bony unions and occlusion were observed in 94 patients. The actual results were basically in accordance with that of virtual surgery. The actual deviation between postoperative CT and preoperative virtual surgical planning was no more than 1 mm matched by computer software. All patients reported their facial appearance were excellent or good at 1 year postoperatively. Conclusion The ideal contour of neomaxilla and neomandible and good function with dental rehabilitation can be gained after accurate maxillary and mandibular reconstruction with vascularized osteomyocutaneous flap using virtual surgery.

Key words: Virtual surgery, Jaw tumor, Maxillary reconstruction, Mandibular reconstruction, Vascularized osteomyocutaneous flap

CLC Number: 

  • R782

Figure 1

Preoperative maxillary virtual surgical planning and stereomodels and templates produced by 3D-printing"

Figure 2

Preoperative mandibular virtual surgical planning and stereomodel and template produced by 3D-printing"

Figure 3

Preoperative, intraoperative, and postoperative photos of right maxillary reconstruction"

Figure 4

Preoperative, intraoperative, and postoperative photos of left mandibular reconstruction"

Table 1

Surgical data in 94 patients"

颌骨 供区 病例数 缺损类型 平均取骨长度(cm) 骨截开数 完成义齿修复病例数
上颌骨 腓骨 34 2b、2c、3b、3d、5 10.7 2~3 15
下颌骨 腓骨 42 L、LC、H、HC、LCL、HCL 14.9 0~3 17
髂骨 16 L、LC、H 6.8 0~1 10
肩胛骨 2 H 4.7 0 0
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