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CC BY-NC 4.0 · Arch Plast Surg 2014; 41(05): 584-587
DOI: 10.5999/aps.2014.41.5.584
Idea and Innovation

Computer Simulation Surgery for Mandibular Reconstruction Using a Fibular Osteotomy Guide

Woo Shik Jeong
Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
,
Jong Woo Choi
Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
,
Seung Ho Choi
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

Keywords

Surgery, plastic - Head and neck neoplasms - Mandibular reconstruction - Free tissue flaps - Computer simulation


Publication History

Received: 04 December 2013

Accepted: 02 March 2014

Article published online:
02 June 2022

© 2014. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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