Fibular osteofasciocutaneous flap in computer-assisted mandibular reconstruction: technical aspects in oral malignancies.
Virtual surgical planning technology in head and neck surgery is witnessing strong growth. In the literature, the validity of the method from the point of view of accuracy and clinical utility has been widely documented, especially for bone modelling. To date, however, with its increased use in head and neck oncology, and consequently the increased need for bone and soft tissue reconstruction, is important to carry out the virtual programme considering not only bone reconstruction but also all aspects related to the reconstruction of soft tissue using composite flaps. We describe our approach to virtual planning in the case of composite flaps. The study reports six consecutive patients with malignant disease requiring mandibular bone and soft tissue reconstruction using fibular osteocutaneous flaps. In all six patients, the resection and reconstruction were planned virtually focusing on the position of cutaneous perforator vessels in order to schedule fibula cutting guides. There were no complications in all six cases. The technique described allowed us to schedule composite fibula flaps in mandibular reconstruction virtually with good accuracy of the position of the bone segment in relation to the cutaneous paddle, important for soft tissue reconstruction. Despite the limited number of cases, the preliminary results of the study suggest that this protocol is useful in virtual programmes using composite flaps in mandibular reconstruction. Further investigations are needed.
Department of Oncology, Phd Program in Experimental Medicine and Therapy, University of Turin, Italy.
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M
Berrone
FPO IRCSS, Candiolo Cancer Institute, Head & Neck Oncology Unit, Candiolo, Turin, Italy.
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E
Crosetti
Microsurgery Unit, Department of Orthopaedics and Traumatology, Orthopaedic and Trauma Center CTO, Turin, Italy.
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PL
Tos
Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Italy.
M
M
Pentenero
Department of Oncology, Otolaryngology Unit, University of Turin, Italy.
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G
Succo
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005205:Fascia / Q000637:transplantation; D005260:Female; D005360:Fibula / Q000637:transplantation; D006801:Humans; D008297:Male; D063175:Mandibular Reconstruction / Q000379:methods*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D013524:Surgical Flaps
Computer-assisted mandibular
reconstruction; Fibula harvestin; Fibular osteofasciocutaneous flap; Mandibular reconstruction; Virtual surgical planning