The occlusion-adjusted prefabricated 3D mirror image templates by computer simulation: the image-guided navigation system application in difficult cases of head and neck reconstruction.
Computer applications in head and neck reconstruction are rapidly emerging and create not only a virtual environment for presurgical planning, but also help in image-guided navigational surgery. This study evaluates the use of prefabricated 3-dimensional (3D) mirror image templates made by computer-simulated adjusted occlusions to assist in microvascular prefabricated flap insertion during reconstructive surgery. Five patients underwent tumor ablation surgery in 1999 and survived for 8 years. Four of the patients with malignancy received radiation therapy. All patients in this study suffered from severe malocclusion causing trismus, headache, temporomandibular joint pain, an unsymmetrical face, and the inability of further osseointegrated teeth insertion. They underwent a 3D computer tomography examination and the nonprocessed raw data were sent for computer simulation in adjusting occlusion; thus, a mirror image template could be fabricated for microsurgical flap guidance. The computer simulated occlusion was acceptable and facial symmetry obtained. The use of the template resulted in a shorter operation time and recovery was as expected. The computer-simulated occlusion-adjusted 3D mirror image templates aid in the use of free vascularized bone flaps for restoring continuity to the mandible. The coordinated arch will help with further osseointegration teeth insertion.
Cheng
Hsu-Tang
HT
Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.
Wu
Chao-I
CI
Tseng
Ching-Shiow
CS
Chen
Hung-Chi
HC
Lee
Wu-Song
WS
Chen
Philip Kuo-Ting
PK
Chang
Sophia Chia-Ning
SC
D003198:Computer Simulation; D005153:Facial Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008310:Malocclusion / Q000209:etiology / Q000601:surgery*; D008334:Mandible / Q000601:surgery*; D008336:Mandibular Diseases / Q000601:surgery; D008866:Microsurgery; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D025321:Surgery, Computer-Assisted; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed