title: A Novel Method of Mild to Moderate Parry-Romberg Syndrome Reconstruction: Computer-Assisted Surgery With Mandibular Outer Cortex and Fat Grafting.
abstract: BACKGROUND
  In patients with mild to moderate Parry-Romberg syndrome (PRS), plastic surgeons have mainly focused on the restoration of soft tissue deficiencies. While, bone deficits are easily overlooked. This study developed a new method combines the autologous mandibular outer cortex (MOC) grafting with fat grafting in mild to moderate patients with PRS, and apply computer-assisted techniques to improve the surgical outcomes and accuracy.
  
  
  METHODS
  Seven patients with mild to moderate PRS were prospectively enrolled in the study. Preoperative and 7 days and 6 months postoperative computed tomography (CT) and photographs were performed. Computer-aided design was done based on preoperative CT data. Surgical templates for MOC harvesting and grafting were designed and printed out. The topographic map of fat grafting was generated. The accuracy of MOC bone grafting was evaluated by the MOC thickness relative error, the MOC thickness accuracy at the preop most severe bone atrophy point (preop MSBAP), and the MOC volume accuracy. The percentage volume maintenance of the fat grafting surgery was assessed.
  
  
  RESULTS
  All 7 patients had ideal clinical outcomes with significant improvement in facial symmetry and no major complications happened. The average MOC thickness relative error is 2.85 ± 0.50%. The average MOC thickness accuracy at the preop MSBAP is 3.36 ± 1.13%. The average MOC volume accuracy is 3.41 ± 1.37%. The average percentage volume maintenance of fat grafting is 62.79 ± 5.73%.
  
  
  CONCLUSIONS
  The combination of MOC grafting with fat grafting can be an excellent choice in reconstruction of mild to moderate patients with PRS. Applying computer-assisted techniques offers a reliable and accurate outcome.
authors.affiliation: The Craniofacial Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Qiao
authors.forename: Lai
authors.initials: L
authors.lastname: Gui
authors.forename: Xi
authors.initials: X
authors.lastname: Fu
authors.forename: Feng
authors.initials: F
authors.lastname: Niu
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Liu
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.forename: Meng
authors.initials: M
authors.lastname: Wang
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Yuanrong
authors.initials: Y
authors.lastname: You
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D002681:China; D017076:Computer-Aided Design; D005150:Facial Hemiatrophy / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000473:pathology / Q000637:transplantation; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013518:Surgery, Plastic / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome