Department of Oral and Maxillofacial Surgery, Technische Universität München, Ismaninger Str. 22, D-81675 Munich, Germany.
Department of Oral and Maxillofacial Surgery, Technische Universität München, Ismaninger Str. 22, D-81675 Munich, Germany.
J Craniomaxillofac Surg. 2017 Aug;45(8):1246-1250. doi: 10.1016/j.jcms.2017.04.010. Epub 2017 May 9.
The free osteomyocutaneous fibular flap has become one of the primary options for mandibular reconstruction, because of the later introduction and development of virtual surgical planning (VSP). However, VSP is associated with high additional pre-operative effort and costs. Therefore, the purpose of the study was to develop a new individual cost-effective pre-operative planning concept for free fibula mandible reconstruction and to compare it with VSP regarding clinical parameters and post-operative outcome.
31 patients undergoing mandibular reconstruction with a microvascular free fibular flap were divided into two groups and retrospectively reviewed. For the first group A (18 of 31 patients), an individual method with stererolithographic (STL) models, silicon templates and hand-made cutting guides was used (about 250 € planning costs/patient). For the second group B (13 of 31 patients), VSP including pre-fabricated cutting guides was used (about 2500 € planning costs/patient).
We found no statistically significant differences with respect to intra-operative time of mandibular reconstruction, duration of hospitalisation or post-operative complications between the two groups (p ≥ 0.05).
The surgical outcomes and operative efficiency of this individual and cost-effective planning concept are comparable with the much more expensive complete VSP concept.
游离骨肌皮瓣因其后期引入和发展的虚拟手术规划（VSP）而成为下颌骨重建的主要选择之一。然而，VSP 与高额外的术前工作量和成本相关。因此，本研究的目的是开发一种新的个体化、经济有效的游离腓骨下颌骨重建术前规划概念，并将其与 VSP 在临床参数和术后结果方面进行比较。
回顾性分析了 31 例行游离腓骨瓣下颌骨重建的患者，分为两组。对于第一组 A（31 例中的 18 例），使用个体化方法，包括立体光刻（STL）模型、硅模板和手工制作的切割导板（每个患者约 250 欧元的规划费用）。对于第二组 B（31 例中的 13 例），使用包括预制切割导板的 VSP（每个患者约 2500 欧元的规划费用）。
两组患者在下颌骨重建的手术时间、住院时间或术后并发症方面均无统计学差异（p≥0.05）。
这种个体化、经济有效的规划概念的手术结果和手术效率与昂贵得多的完整 VSP 概念相当。
