Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
Head Neck. 2021 Aug;43(8):2342-2352. doi: 10.1002/hed.26688. Epub 2021 Mar 31.
To determine whether virtual surgical planning and three-dimensional printed cutting guides (3D/VSP) improved radiographic bone union compared to conventional methods (CM) in fibula free flap (FFF) reconstruction of the mandibles.
Retrospective study from the years 2000-2018 at a tertiary hospital. Osseous union was evaluated by a radiologist blinded to each patient's treatment.
Two hundred sixty patients who underwent FFF tissue transfer, 28 with VSP and 3D cutting guides. Bony union was not achieved in 46 (20%) patients who underwent CM compared to 1 (4%) of patients with VSP and guides (p = 0.036). FFF complication was significantly higher in CM with 87 patients (38%) compared to three patients (11%) in 3D/VSP (p = 0.005). Median time to bony union for patients who underwent CM was 1.4 years compared to 0.8 years in 3D/VSP.
3D/VSP reduced the rate of radiographic nonunion and flap-related complications in FFF reconstruction for mandibular defects.
为了确定在游离腓骨瓣（FFF）重建下颌骨中，虚拟手术规划和三维打印截骨导板（3D/VSP）与传统方法（CM）相比是否能提高影像学骨愈合率。
这是一项回顾性研究，于 2000 年至 2018 年在一家三级医院进行。影像学骨愈合由一位对每位患者治疗均不知情的放射科医生进行评估。
260 例患者接受了 FFF 组织转移，其中 28 例患者使用了 VSP 和 3D 截骨导板。CM 组中 46 例（20%）患者未达到骨性愈合，而 VSP 和导板组中仅 1 例（4%）患者未达到骨性愈合（p = 0.036）。CM 组 FFF 并发症发生率明显高于 3D/VSP 组，有 87 例（38%）患者发生并发症，而 3D/VSP 组仅 3 例（11%）患者发生并发症（p = 0.005）。CM 组患者的骨性愈合中位时间为 1.4 年，而 3D/VSP 组为 0.8 年。
3D/VSP 降低了游离腓骨瓣重建下颌骨骨缺损的影像学骨不连和皮瓣相关并发症的发生率。
