title: Evolution of surgical techniques for mandibular reconstruction using free fibula flaps: The next generation.
abstract: Virtual surgical planning (VSP) has contributed to a number of technical innovations in mandible reconstruction. We report on these innovations and the overall evolution of mandible reconstruction using free fibula flaps at our institution.
  
  
  
  We performed a retrospective chart review of all patients who underwent virtually planned free fibula flap reconstruction of the mandible. Comparisons were made between cohorts based on distinct eras related to the virtual planning approach.
  
  
  
  Seventy-six patients underwent a total of 78 VSP-assisted mandible reconstructions with free fibula flaps. Significant differences were noted among the groups with regard to mean number of segments, percentage of flaps that had at least 3 segments, percentage of flaps that had double-barrel components, and innovations per flap.
  
  
  
  VSP-assisted mandible reconstruction has contributed to more complex surgeries at our institution. The technology ensures functional restoration, permitting an optimized aesthetic reconstruction that has not increased operative times or complications. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2066-E2073, 2016.
authors.affiliation: Department of Plastic and Reconstructive Surgery, New York University Langone Medical Center, New York, NY.
authors.forename: Casian
authors.initials: C
authors.lastname: Monaco
authors.affiliation: Department of Plastic and Reconstructive Surgery, New York University Langone Medical Center, New York, NY.
authors.forename: John T
authors.initials: JT
authors.lastname: Stranix
authors.affiliation: Department of Plastic and Reconstructive Surgery, New York University Langone Medical Center, New York, NY.
authors.forename: Tomer
authors.initials: T
authors.lastname: Avraham
authors.affiliation: Department of Plastic and Reconstructive Surgery, New York University Langone Medical Center, New York, NY.|Department of Prosthodontics and Occlusion, New York University College of Dentistry, New York, NY.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Brecht
authors.affiliation: Department of Plastic and Reconstructive Surgery, New York University Langone Medical Center, New York, NY.
authors.forename: Pierre B
authors.initials: PB
authors.lastname: Saadeh
authors.affiliation: Department of Plastic and Reconstructive Surgery, New York University Langone Medical Center, New York, NY.|Department of Oral Maxillofacial Surgery, New York University Langone Medical Center, New York, NY.
authors.forename: David
authors.initials: D
authors.lastname: Hirsch
authors.affiliation: Department of Plastic and Reconstructive Surgery, New York University Langone Medical Center, New York, NY.
authors.forename: Jamie P
authors.initials: JP
authors.lastname: Levine
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D002648:Child; D005260:Female; D005360:Fibula / Q000637:transplantation; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008339:Mandibular Neoplasms / Q000601:surgery*; D063175:Mandibular Reconstruction; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D055815:Young Adult
keywords: free fibula flap; innovation; jaw in a day; mandible reconstruction; virtual surgical planning