Houston, Texas.
From the Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center.
Plast Reconstr Surg. 2018 Feb;141(2):271e-285e. doi: 10.1097/PRS.0000000000004070.
After reading this article, the participant should be able to: 1. Have a basic understanding of virtual planning, rapid prototype modeling, three-dimensional printing, and computer-assisted design and manufacture. 2. Understand the principles of combining virtual planning and vascular mapping. 3. Understand principles of flap choice and design in preoperative planning of free osteocutaneous flaps in mandible and midface reconstruction. 4. Discuss advantages and disadvantages of computer-assisted design and manufacture in reconstruction of advanced oncologic mandible and midface defects.
Virtual planning and rapid prototype modeling are increasingly used in head and neck reconstruction with the aim of achieving superior surgical outcomes in functionally and aesthetically critical areas of the head and neck compared with conventional reconstruction. The reconstructive surgeon must be able to understand this rapidly-advancing technology, along with its advantages and disadvantages. There is no limit to the degree to which patient-specific data may be integrated into the virtual planning process. For example, vascular mapping can be incorporated into virtual planning of mandible or midface reconstruction. Representative mandible and midface cases are presented to illustrate the process of virtual planning. Although virtual planning has become helpful in head and neck reconstruction, its routine use may be limited by logistic challenges, increased acquisition costs, and limited flexibility for intraoperative modifications. Nevertheless, the authors believe that the superior functional and aesthetic results realized with virtual planning outweigh the limitations.
阅读本文后，参与者应能够：1. 对虚拟规划、快速原型建模、三维打印以及计算机辅助设计和制造有基本的了解。2. 理解虚拟规划和血管测绘结合的原理。3. 理解在颌骨和面部中重建游离骨皮瓣的术前规划中皮瓣选择和设计的原则。4. 讨论计算机辅助设计和制造在先进的颌骨和面部肿瘤缺损重建中的优缺点。
与传统重建相比，虚拟规划和快速原型建模越来越多地应用于头颈部重建，旨在实现功能和美学上关键区域的手术结果更优。重建外科医生必须能够理解这项快速发展的技术及其优缺点。患者特定数据可以集成到虚拟规划过程中的程度没有限制。例如，可以将血管测绘纳入下颌骨或面部中重建的虚拟规划中。代表性的下颌骨和面部病例被提出来说明虚拟规划的过程。尽管虚拟规划在头颈部重建中已经变得很有帮助，但由于后勤挑战、增加的获取成本以及术中修改的有限灵活性，其常规使用可能受到限制。然而，作者认为，虚拟规划实现的更好的功能和美学结果超过了其局限性。
