Cedillo Marco, Côrdova Sofia, Larralde Sebastián, Martínez Fabián, Sandoval Fernando, Suntaxi Felipe
Department of Oral and Maxillofacial Surgery, Universidad San Francisco de Quito, Faculty of Dentistry, Cumbaya Campus, Quito, Ecuador.
Department of Oral and Maxillofacial Surgery - S.O.L.C.A Hospital, Universidad San Francisco de Quito, Faculty of Dentistry, Cumbayá Campus, Quito, Ecuador.
J Craniofac Surg. 2022 Oct 1;33(7):e680-e685. doi: 10.1097/SCS.0000000000008539. Epub 2022 Feb 10.
Mandibular reconstruction is a challenging procedure, especially in cancer patients with defects that are greater than 6 cm. Free vascularized fibular flap is the gold standard treatment in these cases since it allows three-dimensional restoration of the lost segments after ablative surgery in addition to providing the possibility of a subsequent implant-supported rehabilitation improving the functional and aesthetic outcomes of the surgery.To obtain accurate results, preoperative planning must be done with detail. Approaches for the preoperative planning include both the conventional analog planning and the virtual planning that are valid alternatives in meeting the trans-surgical requirements.This study makes a comparative analysis of 2 clinical cases with a diagnosis of squamous cell carcinoma that were reconstructed using a vascularized fibular free flap. The first case was planned using the conventional analog method whereas the second case was planned using the virtual planning approach.The impact of virtual planning and conventional analog planning on preoperative planning time, ischemia period, and total surgical time is analyzed according to the experience obtained in the cases presented. In addition, the authors described the technique used for each planning method along with a literature review in which the results are contrasted and discussed.
下颌骨重建是一项具有挑战性的手术，尤其是对于缺损大于6厘米的癌症患者。游离血管化腓骨瓣是这些病例的金标准治疗方法，因为它不仅能在切除手术后对缺失节段进行三维重建，还能为后续种植体支持的修复提供可能，从而改善手术的功能和美学效果。为了获得准确的结果，术前必须进行详细的规划。术前规划方法包括传统的模拟规划和虚拟规划，这两种方法都是满足跨手术要求的有效选择。本研究对2例诊断为鳞状细胞癌并使用游离血管化腓骨瓣进行重建的临床病例进行了对比分析。第一例采用传统模拟方法进行规划，而第二例采用虚拟规划方法。根据所呈现病例的经验，分析虚拟规划和传统模拟规划对术前规划时间、缺血期和总手术时间的影响。此外，作者描述了每种规划方法所使用的技术，并进行了文献综述，对结果进行了对比和讨论。
