The vascularized free fibular flap which was used to reconstruct mandibular defects with the aid of digital surgical techniques
MING Huawei
HE Yun
YUAN Zhongyi
ZHANG Xing'an
JIA Jiaxin
WANG Huadong
CHEN Fangyuan
TAN Xiaoyao
Abstract：Objective To assess the clinical utility of digitally-assisted vascularized free fibula flaps in reconstructing mandibular defects.Methods We examined seven patients treated for mandibular ameloblastoma at the Department of Oral and Maxillofacial Surgery,Nanchong Central Hospital,from October 2020 to October 2023.Preoperative CT scans of patients'faces and bilateral lower limbs were conducted to acquire DICOM data,which were then imported into a surgical planning software for virtual surgery.Utilizing the virtual sur-gical designs,osteotomy guides for both fibula and mandible,along with preoperative and postoperative cranial models,were fabricated us-ing 3D printing technology.These models facilitated the pre-shaping of mandibular reconstruction plates in preparation for surgery.The mandibular defects were reconstructed using the pre-shaped plates and fibula flaps,guided by the osteotomy templates.Results Surgery was performed in accordance with the preoperative virtual plans across all cases,successfully positioning the pre-shaped reconstruction plates.The fibula flaps,after contouring,aligned snugly against the reconstruction plates and matched the mandibular segments accurately.Post-surgery,all fibula flaps were viable,facial symmetry was generally preserved,occlusion relationships were favorable,and masticatory function was satisfactory.Only one obese patient experienced fat liquefaction at the donor site,which resolved after secondary healing fol-lowing irrigation and dressing changes.All other patients achieved primary healing at both donor and recipient sites.Patients commenced partial weight-bearing one week post-surgery and resumed normal walking within three months,without any complications.Conclusion The use of digital surgical technologies in the reconstruction of mandibular defects with vascularized free fibula flaps enables precise and visu-ally-guided surgical procedures.This approach significantly reduces dependence on clinical experience,enhancing both operational effi-ciency and the functional restoration of the mandible.
Keywords：Mandibular reconstructionDigital surgeryFibula flapSurgical guide plate3D printing
Publication Date：2025-04-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 206-210 )