Nahass George R, Kaplan Nicolas, Scharf Isabel, Saini Devansh, Bou Zeid Naji, Kazmouz Sobhi, Zhao Linping, Alkureishi Lee W T
Plastic Surgery, University of Illinois Chicago, 811 S Paulina, Chicago, IL, 60612, USA.
Plastic Surgery, Shriners Children's Chicago Hospital, Chicago, IL, 60707, USA.
Int J Comput Assist Radiol Surg. 2025 May;20(5):891-900. doi: 10.1007/s11548-025-03324-1. Epub 2025 Feb 19.
The fibula-free flap (FFF) is a valuable reconstructive technique in maxillofacial surgery; however, the assessment of osteotomy accuracy remains challenging. We devised two novel methodologies to compare planned and postoperative osteotomies in FFF reconstructions that minimized user input but would still generalize to other operations involving the analysis of osteotomies.
Our approaches leverage basic mathematics to derive both quantitative and qualitative insights about the relationship of the postoperative osteotomy to the planned model. We have coined our methods 'analysis by a shared reference angle' and 'Euler angle analysis.'
In addition to describing our algorithm and the clinical utility, we present a thorough validation of both methods. Our algorithm is highly repeatable in an intraobserver repeatability test and provides information about the overall accuracy as well as geometric specifics of the deviation from the planned reconstruction.
Our algorithm is a novel and robust method for assessing the osteotomy accuracy of FFF reconstructions. This approach has no reliance on the overall position of the reconstruction, which is valuable due to the multiple factors that may influence the outcome of FFF reconstructions. Additionally, while our approach relies on anatomical features for landmark selections, the flexibility in our approach makes it applicable to evaluate any operation involving osteotomies.
游离腓骨瓣（FFF）是颌面外科一种有价值的重建技术；然而，截骨准确性的评估仍然具有挑战性。我们设计了两种新颖的方法来比较FFF重建中计划截骨与术后截骨情况，这两种方法将用户输入降至最低，但仍可推广到其他涉及截骨分析的手术中。
我们的方法利用基础数学来得出关于术后截骨与计划模型之间关系的定量和定性见解。我们将我们的方法命名为“共享参考角分析”和“欧拉角分析”。
除了描述我们的算法和临床效用外，我们还对这两种方法进行了全面验证。我们的算法在观察者内重复性测试中具有高度可重复性，并提供有关整体准确性以及与计划重建偏差的几何细节的信息。
我们的算法是一种评估FFF重建截骨准确性的新颖且稳健的方法。这种方法不依赖于重建的整体位置，鉴于可能影响FFF重建结果的多种因素，这一点很有价值。此外，虽然我们的方法依赖于解剖特征来选择地标，但我们方法的灵活性使其适用于评估任何涉及截骨的手术。
