ENT Department, Neck Surgery and Maxillofacial Surgery, Gui de Chauliac University Hospital, Montpellier University School of Medicine, Montpellier, France; LIRMM, University of Montpellier, CNRS, Montpellier, France.
LIRMM, University of Montpellier, CNRS, Montpellier, France.
Int J Oral Maxillofac Surg. 2024 Apr;53(4):343-346. doi: 10.1016/j.ijom.2023.07.010. Epub 2023 Aug 19.
Various methods currently exist to guide fibular osteotomy positioning in fibula free flap mandibular reconstruction, but patient-specific navigation methods and cutting guides require experience, and may be time-consuming and/or expensive. This study describes a robot-guided osteotomy technique for mandible reconstruction using a fibula free flap according to virtual preoperative planning. The method was assessed on five 3D-printed models and a cadaveric model. The precision of the robot-guided osteotomy was evaluated by measuring the deviations between the lengths and angles of the fragments obtained and those of the virtual planning. The average deviation of the anterior and posterior crest lengths was 0.42 ± 0.29 mm for the 3D-printed models and 1.00 ± 0.53 mm for the cadaveric model. The average angle deviation was 1.90 ± 1.22° and 1.94 ± 0.69° for the 3D-printed and cadaveric models, respectively. The results of this preclinical study revealed that fibular osteotomy positioning guidance using a robot-positioned cutting guide may be a precise, easy-to-use technique that could be tailored for fibula free flap mandibular reconstruction.
目前存在多种方法来指导游离腓骨瓣下颌骨重建中的腓骨截骨定位，但患者特异性导航方法和截骨导板需要经验，并且可能耗时且/或昂贵。本研究描述了一种根据虚拟术前规划使用游离腓骨瓣进行下颌骨重建的机器人引导截骨技术。该方法在五个 3D 打印模型和一个尸体模型上进行了评估。通过测量获得的骨段的长度和角度与虚拟规划之间的偏差来评估机器人引导截骨的精度。对于 3D 打印模型，前嵴和后嵴长度的平均偏差为 0.42 ± 0.29 毫米，对于尸体模型则为 1.00 ± 0.53 毫米。对于 3D 打印和尸体模型，角度偏差的平均值分别为 1.90 ± 1.22°和 1.94 ± 0.69°。这项临床前研究的结果表明，使用机器人定位截骨导板进行腓骨截骨定位引导可能是一种精确、易于使用的技术，可针对游离腓骨瓣下颌骨重建进行定制。
