Diaddigo Sarah E, LaValley Myles N, Dagi Alexander F, Kuonqui Kevin, Shen Yong, Tyler Wakenda J, Bogue Jarrod T
From the Department of Surgery, Division of Plastic Surgery, NewYork-Presbyterian Hospital, Columbia University, New York, N.Y.
Plast Reconstr Surg Glob Open. 2024 Sep 13;12(9):e6161. doi: 10.1097/GOX.0000000000006161. eCollection 2024 Sep.
Three-dimensional (3D) planning and manufacturing technologies have become integral to head and neck reconstruction following tumor resection. These technologies facilitate the prototyping of patient-specific solutions in both digital and physical form. Three-dimensional tumor models and cutting guides help conceptualize and verify the surgical approach, as well as serve as a blueprint for reconstruction. Computer-aided renderings have been shown to add precision to bony contouring to achieve functional and aesthetic goals following tumor resection, such as in mastication, oral competence, speech, and symmetric facial aesthetics. Three-dimensional technologies have also been introduced in orthopedic oncology, making limb-salvage surgery the mainstay of treatment in cases where amputation was historically required. The advent of customized 3D cutting guides and plates allows surgeons to spare surrounding healthy tissue, markedly enhancing postoperative quality of life and significantly reducing associated morbidities. Borrowing from these applications of 3D planning and modeling, our institution has recently implemented these technologies for the reconstructive planning of soft tissue defects following sarcoma resection. Here we present a series of cases that demonstrate the workflow and clinical outcomes associated with the utilization of 3D planning techniques in orthoplastic surgery.
三维(3D)规划和制造技术已成为肿瘤切除术后头颈部重建不可或缺的一部分。这些技术有助于以数字和实体形式制作针对患者的解决方案原型。三维肿瘤模型和切割导板有助于构思和验证手术方法,并作为重建的蓝图。计算机辅助渲染已被证明能提高骨轮廓塑造的精度,以在肿瘤切除后实现功能和美学目标,如咀嚼、口腔功能、言语和对称的面部美学。三维技术也已引入骨肿瘤学领域,使保肢手术成为过去需要截肢的病例的主要治疗方法。定制的3D切割导板和钢板的出现使外科医生能够保留周围健康组织,显著提高术后生活质量并大幅降低相关发病率。借鉴这些3D规划和建模的应用,我们机构最近将这些技术应用于肉瘤切除术后软组织缺损的重建规划。在此,我们展示一系列病例,以说明在整形外科手术中使用3D规划技术的工作流程和临床结果。