title: [Study on accuracy of virtual surgical planning in free fibula mandibular reconstruction by using SurgiCase software].
abstract: OBJECTIVE
  To evaluate the directional significance of SurgiCase software in free fibula mandibular reconstruction.
  
  
  METHODS
  Between September 2010 and March 2012, 10 patients with mandibular defect underwent free fibula mandibular reconstruction. There were 7 males and 3 females, with an age range of 19-43 years (mean, 27 years). The extent of lesions was 7 cm x 5 cm to 16 cm x 8 cm. In each case, three-dimensional spiral CT scan of the maxilla, mandible, and fibula was obtained before surgery. The CT data were imported into the SurgiCase software and the virtual surgery planning was performed. After that, the mandibular rapid prototyping was made according to customized design. The reconstruction surgery was then carried out using these preoperative data. During actual surgery, the extent of mandibular defect was from 6 cm x 3 cm to 16 cm x 5 cm; the length of fibula which was used to reconstruct mandible was 6-17 cm; and the area of flap was from 6 cm x 5 cm to 16 cm x 6 cm.
  
  
  RESULTS
  Preoperative data could not be applied because the intraoperative size of tumor was larger than preoperative design in 1 case of mandibular ameloblastoma, and the fibula was shaped according to the actual osteotomy location; operations were performed successfully according to preoperative design in the other 9 patients. The operation time was 5-7 hours (mean, 6 hours). Primary healing of incision was obtained, without early complications. Ten patients were followed up 1 year. At last follow-up, 8 patients were satisfactory with the appearance and 2 patients complained with unsatisfied wide facial pattern. The panoramic radiograghs showed good bone healing. The range of mouth opening was 2.5-3.5 cm.
  
  
  CONCLUSIONS
  SurgiCase software can provide precise data for free fibula mandibular reconstruction during surgery. It can be applied widely in clinic.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang Liaoning, 110002, P R China.
authors.forename: Guangqi
authors.initials: G
authors.lastname: Yan
authors.forename: Xue
authors.initials: X
authors.lastname: Wang
authors.forename: Xuexin
authors.initials: X
authors.lastname: Tan
authors.forename: Xukai
authors.initials: X
authors.lastname: Wang
authors.forename: Mingliang
authors.initials: M
authors.lastname: Yang
authors.forename: Li
authors.initials: L
authors.lastname: Lu
mesh_terms: D000328:Adult; D000564:Ameloblastoma / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods*; D017076:Computer-Aided Design; D005260:Female; D005360:Fibula / Q000098:blood supply / Q000637:transplantation*; D058752:Free Tissue Flaps / Q000098:blood supply; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000601:surgery; D063168:Mandibular Osteotomy; D063175:Mandibular Reconstruction / Q000295:instrumentation / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D016038:Skin Transplantation / Q000379:methods; D012984:Software; D016896:Treatment Outcome; D014584:User-Computer Interface; D055815:Young Adult