Navigation-guided fibula free flap for mandibular reconstruction: A proof of concept study
| Autor: | Marcin Majak, Piotr Pietruski, Ewelina Światek-Najwer, Magdalena Żuk, Marta Świecka, Janusz Jaworowski, Michał Popek, Maciej Mazurek |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Free flap Osteotomy Free Tissue Flaps Proof of Concept Study Imaging phantom 03 medical and health sciences 0302 clinical medicine Imaging Three-Dimensional Medicine Humans Fibula Orthodontics Computer-assisted surgery business.industry 030206 dentistry Surgery Image-guided surgery Surgery Computer-Assisted Proof of concept 030220 oncology & carcinogenesis Mandibular Reconstruction business Fiducial marker Tomography X-Ray Computed |
| Zdroj: | Journal of plastic, reconstructiveaesthetic surgery : JPRAS. 72(4) |
| ISSN: | 1878-0539 |
| Popis: | Summary Objective To analyze a novel technique of supporting fibula free flap harvest and fabrication with intraoperative navigation technology. Materials and methods In the first phase of the study, navigation accuracy achieved with two registration methods, namely, point-pair and hybrid technique utilizing point-pair with surface matching, were evaluated in the form of the fiducial (FRE) and target registration error (TRE). Next, a series of 42 simulated navigated fibular osteotomies were conducted on specially manufactured lower leg phantom. Postoperative results were analyzed in the form of the angular and position deviations between the virtually planned and the obtained osteotomies. Results Mean FRE values obtained with point-pair and hybrid registration methods were 1.82 ± 0.96 mm and 1.41 ± 0.44 mm, respectively. Mean TRE value in the fibula region was 2.00 ± 0.67 mm for the first method and 1.51 ± 0.72 mm for the second. For all performed surgeries, the total mean angular deviation between the planned and actual osteotomy trajectory equaled 3.66° ± 3.60°. The total mean position disparity of osteotomy control points was 1.85 ± 0.99 mm. Conclusions Navigation-guided free fibula flap harvest and fabrication, due to encouraging study results and its superiority over currently popular cutting guides in many clinical aspects, may become a routine operative procedure for the reconstruction of complex mandibular defects. The presented method is especially well suited for plastic and maxillofacial surgery. |
| Databáze: | OpenAIRE |
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