Patel Harsh, Saadat Nariman, Ho Allen S, Mallen-St Clair Jon
Plastic and Reconstructive Surgery, University of California, Los Angeles School of Medicine, Los Angeles, USA.
Oral and Maxillofacial Surgery, Cedars-Sinai Medical Center, Los Angeles, USA.
Cureus. 2020 Aug 12;12(8):e9696. doi: 10.7759/cureus.9696.
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a rare but potentially devastating complication of extended use of bisphosphonates. fibula free flaps (FFFs) are the gold standard of mandibular reconstruction. Virtual surgical planning (VSP) is a technique that utilizes high-definition three-dimensional reconstructions that enable the production of highly accurate intra-operative surgical guides and templates that help guide osteotomies and fibula contouring. The aim of this report is to highlight the value of VSP in the surgical management of advanced BRONJ. We report a case study of a woman with advanced BRONJ that required an angle-to-angle mandibular resection with subsequent reconstruction with an FFF. VSP was used to improve the accuracy of the reconstruction and minimize ischemia time. We present the first reported case of the successful implementation of VSP for the planning of FFF reconstruction for a woman with advanced symptomatic BRONJ that had failed conservative measures.
双膦酸盐相关颌骨坏死（BRONJ）是长期使用双膦酸盐类药物引发的一种罕见但可能具有毁灭性的并发症。游离腓骨瓣（FFFs）是下颌骨重建的金标准。虚拟手术规划（VSP）是一种利用高清三维重建的技术，能够制作高度精确的术中手术导板和模板，有助于指导截骨术和腓骨塑形。本报告的目的是强调VSP在晚期BRONJ手术治疗中的价值。我们报告了一例晚期BRONJ女性患者的病例研究，该患者需要进行角对角下颌骨切除术，随后用FFFs进行重建。VSP用于提高重建的准确性并缩短缺血时间。我们首次报道了成功应用VSP为一名保守治疗失败的晚期有症状BRONJ女性患者规划FFFs重建的病例。
