title: V-stand--a versatile surgical platform for oromandibular reconstruction using a 3-dimensional virtual modeling system.
abstract: OBJECTIVE
  The challenge of oromandibular reconstruction (OMR) after oncologic resections has been repeatedly addressed in the literature. Although final oncologic margins can be decided only during surgery, various attempts have been made to create an ideal and accurate platform for OMR. The purpose of this article is to present the V-stand, a versatile surgical platform for OMR using a 3-dimensional (3D) virtual modeling system.
  
  
  METHODS
  Seventeen patients requiring an OMR were included in the study. A presurgical computed tomogram was obtained and virtual resection and reconstruction with a free fibular flap were planned using 3D virtual surgery software. The mandible was reconstructed intraoperatively using the V-stand, which served as a template for the lower border of the mandible and the lateral aspects of the stand were fixed to the proximal mandibular segments using 2-mm titanium screws.
  
  
  RESULTS
  Patients' average age was 53 years (5 to 72 yr). Median follow-up was 19 months (2 to 35 months). All reconstructed mandibles resulted in good function and esthetics.
  
  
  CONCLUSIONS
  The V-stand offers a safe and time-efficient method for OMR. It provides an excellent means for accurate spatial positioning of a fibular free flap. The V-stand preserves the original dimensions of the reconstructed mandible and can overcome surgical ablation modifications because it is not dependent on the precision of the resection, but rather provides a mold for the entire mandible.
authors.affiliation: Attending Physician, Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Vadim
authors.initials: V
authors.lastname: Reiser
authors.affiliation: Attending Physician, Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Hebrew University-Hadassah, Jerusalem, Israel. Electronic address: Michael.alterman@gmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Alterman
authors.affiliation: Attending Physician, Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Shuster
authors.affiliation: Attending Physician, Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Shlomi
authors.initials: S
authors.lastname: Kleinman
authors.affiliation: Unit Head, Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Shlomi
authors.affiliation: Attending Physician, Department of Reconstructive and Aesthetic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Ravit
authors.initials: R
authors.lastname: Yanko-Arzi
authors.affiliation: Attending Physician, Department of Reconstructive and Aesthetic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Arik
authors.initials: A
authors.lastname: Zaretski
authors.affiliation: Department Head, Department of Plastic Surgery, Carmel Medical Center, Haifa, Israel.
authors.forename: Aharon
authors.initials: A
authors.lastname: Amir
authors.affiliation: Professor, Department Head, Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Dan M
authors.initials: DM
authors.lastname: Fliss
mesh_terms: D000328:Adult; D000368:Aged; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods; D002675:Child, Preschool; D017076:Computer-Aided Design; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery; D063175:Mandibular Reconstruction / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010347:Patient Care Planning; D066330:Printing, Three-Dimensional; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D014584:User-Computer Interface; D055815:Young Adult