Evaluation of computer-assisted jaw reconstruction with free vascularized fibular flap compared to conventional surgery: a clinical pilot study

Abstract

Background: The introduction of computer-assisted surgery was a milestone in functional reconstructions of facial skeletal defects.

Patients and methods: We compared five computer-assisted and five conventional reconstructions with fibular grafts in the course of a pilot study. A rapid prototyping guide translated the computer-assisted surgery plan into intraoperative utilizable models. We intraoperatively measured the time needed for shaping the graft to the recipient site and the ischaemic time. Furthermore, the size of donor site defect compared to the required transplant length was evaluated.

Results: Shaping procedure and ischaemic time turned out significantly shorter when compared to conventional surgery without cutting guide (p = 0.014). Using surgical guides, there was no change between the defect size of the fibula and the necessary transplant size. In conventional surgery, a mean change of 1.92 cm occurred (p = 0.001).

Conclusion: The surgical guide significantly reduced shaping time and consequently ischaemic time. These factors can influence flap survival. The fibular donor site defect was downsized.