title: Reconstruction of maxillary defects with free fibula flap assisted by computer techniques.
abstract: OBJECTIVE
  Free fibula flaps are widely used for maxillary reconstruction. The three-dimensional position of the fibula flap is very difficult to control in conventional operations based solely on the surgeon's experience. We aimed to improve this surgery by using computerized techniques.
  
  
  METHODS
  Twenty-seven patients with maxillary tumors underwent maxillectomy and free fibula flap reconstruction in our department between 2011 and 2013. Virtual planning and surgical navigation were used for eight patients, and conventional surgery was performed in 19 patients. The three-dimensional fibular positions were evaluated in the two groups. Differences between the postoperative position of the fibular segments and the virtual plans were evaluated in the computer-assisted surgery group.
  
  
  RESULTS
  The three-dimensional position of the fibula flap in the computer-assisted surgery group, including the vertical distance (p = 0.013), horizontal position (p = 0.019) and extension of the posterior end (p = 0.041), was significantly more accurate and nearer to the ideal position than that in the conventional surgery group. The average difference between the actual postoperative position of the fibular segments and the virtual plan in the computer-assisted surgery group was <5 mm.
  
  
  CONCLUSIONS
  Application of computer-assisted techniques such as virtual planning and surgical navigation significantly improve the clinical outcomes of maxillary reconstruction with free fibula flaps.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
authors.forename: W B
authors.initials: WB
authors.lastname: Zhang
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
authors.forename: X J
authors.initials: XJ
authors.lastname: Liu
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
authors.forename: C
authors.initials: C
authors.lastname: Mao
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
authors.forename: C B
authors.initials: CB
authors.lastname: Guo
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
authors.forename: G Y
authors.initials: GY
authors.lastname: Yu
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China. Electronic address: pxpengxin@263.net.
authors.forename: X
authors.initials: X
authors.lastname: Peng
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D017076:Computer-Aided Design; D005260:Female; D005360:Fibula / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000601:surgery*; D008875:Middle Aged; D009915:Orbit / Q000601:surgery; D010347:Patient Care Planning; D019651:Plastic Surgery Procedures / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013524:Surgical Flaps / Q000637:transplantation*; D013526:Surgical Mesh; D014057:Tomography, X-Ray Computed / Q000379:methods; D060053:Transplant Donor Site / Q000601:surgery; D016896:Treatment Outcome; D014584:User-Computer Interface
keywords: Computer-assisted techniques; Free fibula flap; Maxillary defect