Berrone M, Crosetti E, Tos P L, Pentenero M, Succo G
Department of Oncology, Phd Program in Experimental Medicine and Therapy, University of Turin, Italy.
FPO IRCSS, Candiolo Cancer Institute, Head & Neck Oncology Unit, Candiolo, Turin, Italy.
Acta Otorhinolaryngol Ital. 2016 Dec;36(6):469-478. doi: 10.14639/0392-100X-1282.
Virtual surgical planning technology in head and neck surgery is witnessing strong growth. In the literature, the validity of the method from the point of view of accuracy and clinical utility has been widely documented, especially for bone modelling. To date, however, with its increased use in head and neck oncology, and consequently the increased need for bone and soft tissue reconstruction, is important to carry out the virtual programme considering not only bone reconstruction but also all aspects related to the reconstruction of soft tissue using composite flaps. We describe our approach to virtual planning in the case of composite flaps. The study reports six consecutive patients with malignant disease requiring mandibular bone and soft tissue reconstruction using fibular osteocutaneous flaps. In all six patients, the resection and reconstruction were planned virtually focusing on the position of cutaneous perforator vessels in order to schedule fibula cutting guides. There were no complications in all six cases. The technique described allowed us to schedule composite fibula flaps in mandibular reconstruction virtually with good accuracy of the position of the bone segment in relation to the cutaneous paddle, important for soft tissue reconstruction. Despite the limited number of cases, the preliminary results of the study suggest that this protocol is useful in virtual programmes using composite flaps in mandibular reconstruction. Further investigations are needed.
头颈部手术中的虚拟手术规划技术正在迅猛发展。在文献中，该方法从准确性和临床实用性角度的有效性已得到广泛记载，尤其是在骨建模方面。然而，迄今为止，随着其在头颈部肿瘤学中的应用增加，以及随之而来对骨和软组织重建需求的增加，在进行虚拟程序时，不仅要考虑骨重建，还要考虑使用复合皮瓣进行软组织重建的所有相关方面，这一点很重要。我们描述了在复合皮瓣情况下的虚拟规划方法。该研究报告了连续6例患有恶性疾病的患者，他们需要使用腓骨骨皮瓣进行下颌骨和软组织重建。在所有6例患者中，虚拟规划了切除和重建，重点关注皮穿支血管的位置，以便安排腓骨切割导向。所有6例均无并发症。所描述的技术使我们能够在虚拟情况下为下颌骨重建安排复合腓骨皮瓣，骨段相对于皮瓣的位置具有良好的准确性，这对软组织重建很重要。尽管病例数量有限，但该研究的初步结果表明，该方案在使用复合皮瓣进行下颌骨重建的虚拟程序中是有用的。还需要进一步研究。
