Anatomical Landmark-guided Strategy for Computer-assisted Reconstruction of Infrastructure Maxillary Defects Using Free Fibula Flap
Background:. Computer-assisted surgery in head and neck reconstruction yields predictable and favorable clinical outcomes. However, there is a lack in the optimal arrangement of the fibula bone segments to re-establish the function and aesthetics of the maxilla. Methods:. This study proposed a novel...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-03-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006626 |
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| author | Songying Wu, BDS Jingya Jane Pu, BDS, MDS Edmond Ho Nang Pow, BDS, MDS, PhD Pui Hang Leung, BSc Xing-Na Yu, BDS, MDS Yu-Xiong Su, MD, PhD Wei-Fa Yang, BDS, MDS, PhD |
| author_facet | Songying Wu, BDS Jingya Jane Pu, BDS, MDS Edmond Ho Nang Pow, BDS, MDS, PhD Pui Hang Leung, BSc Xing-Na Yu, BDS, MDS Yu-Xiong Su, MD, PhD Wei-Fa Yang, BDS, MDS, PhD |
| author_sort | Songying Wu, BDS |
| collection | DOAJ |
| description | Background:. Computer-assisted surgery in head and neck reconstruction yields predictable and favorable clinical outcomes. However, there is a lack in the optimal arrangement of the fibula bone segments to re-establish the function and aesthetics of the maxilla.
Methods:. This study proposed a novel anatomical landmark-guided strategy for the virtual surgical planning (VSP) of infrastructure maxilla reconstruction using a free fibula flap. The optimal positioning of fibula segments was validated with a retrospective clinical study. Patients who underwent computer-assisted infrastructure maxillectomy and reconstruction with a free fibula flap from May 2017 to April 2024 were reviewed. Reproducibility of the landmarks and associated clinical parameters was assessed in VSP compared with the preoperative maxilla. Additionally, a structured quantitative approach was adopted for postoperative surgical outcome analysis by comparison of the postoperative maxilla and the VSP.
Results:. Twenty patients fulfilled the criteria of this study. In 11 cases, we conformed to the proposed reconstruction strategy (group A). In 9 cases, we adopted a modified approach (group B) with deviations in the count of fibula segments and positioning strategy. In group A, the pooled median landmark error was 2.19 mm (interquartile range, 1.63–2.91 mm) in the VSP compared with the preoperative maxilla; in group B, the error was 4.54 mm (interquartile range, 2.05–6.15 mm). The clinical parameters demonstrated satisfactory recapture of the alveolar arch and maxillary width.
Conclusions:. This anatomical landmark-guided strategy was validated with satisfactory reproducibility of the quantitative metrics in the VSP. The anatomical landmarks and associated clinical parameters provided a structured quantitative approach for postoperative analysis of computer-assisted maxillary reconstruction using FFFs. |
| format | Article |
| id | doaj-art-770bc84e2c4f4b51b0177155f2790915 |
| institution | Kabale University |
| issn | 2169-7574 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-770bc84e2c4f4b51b0177155f27909152025-08-20T03:40:17ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-03-01133e662610.1097/GOX.0000000000006626202503000-00081Anatomical Landmark-guided Strategy for Computer-assisted Reconstruction of Infrastructure Maxillary Defects Using Free Fibula FlapSongying Wu, BDS0Jingya Jane Pu, BDS, MDS1Edmond Ho Nang Pow, BDS, MDS, PhD2Pui Hang Leung, BSc3Xing-Na Yu, BDS, MDS4Yu-Xiong Su, MD, PhD5Wei-Fa Yang, BDS, MDS, PhD6From the * Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, ChinaFrom the * Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China† Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China.From the * Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, ChinaFrom the * Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, ChinaFrom the * Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, ChinaFrom the * Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, ChinaBackground:. Computer-assisted surgery in head and neck reconstruction yields predictable and favorable clinical outcomes. However, there is a lack in the optimal arrangement of the fibula bone segments to re-establish the function and aesthetics of the maxilla. Methods:. This study proposed a novel anatomical landmark-guided strategy for the virtual surgical planning (VSP) of infrastructure maxilla reconstruction using a free fibula flap. The optimal positioning of fibula segments was validated with a retrospective clinical study. Patients who underwent computer-assisted infrastructure maxillectomy and reconstruction with a free fibula flap from May 2017 to April 2024 were reviewed. Reproducibility of the landmarks and associated clinical parameters was assessed in VSP compared with the preoperative maxilla. Additionally, a structured quantitative approach was adopted for postoperative surgical outcome analysis by comparison of the postoperative maxilla and the VSP. Results:. Twenty patients fulfilled the criteria of this study. In 11 cases, we conformed to the proposed reconstruction strategy (group A). In 9 cases, we adopted a modified approach (group B) with deviations in the count of fibula segments and positioning strategy. In group A, the pooled median landmark error was 2.19 mm (interquartile range, 1.63–2.91 mm) in the VSP compared with the preoperative maxilla; in group B, the error was 4.54 mm (interquartile range, 2.05–6.15 mm). The clinical parameters demonstrated satisfactory recapture of the alveolar arch and maxillary width. Conclusions:. This anatomical landmark-guided strategy was validated with satisfactory reproducibility of the quantitative metrics in the VSP. The anatomical landmarks and associated clinical parameters provided a structured quantitative approach for postoperative analysis of computer-assisted maxillary reconstruction using FFFs.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006626 |
| spellingShingle | Songying Wu, BDS Jingya Jane Pu, BDS, MDS Edmond Ho Nang Pow, BDS, MDS, PhD Pui Hang Leung, BSc Xing-Na Yu, BDS, MDS Yu-Xiong Su, MD, PhD Wei-Fa Yang, BDS, MDS, PhD Anatomical Landmark-guided Strategy for Computer-assisted Reconstruction of Infrastructure Maxillary Defects Using Free Fibula Flap Plastic and Reconstructive Surgery, Global Open |
| title | Anatomical Landmark-guided Strategy for Computer-assisted Reconstruction of Infrastructure Maxillary Defects Using Free Fibula Flap |
| title_full | Anatomical Landmark-guided Strategy for Computer-assisted Reconstruction of Infrastructure Maxillary Defects Using Free Fibula Flap |
| title_fullStr | Anatomical Landmark-guided Strategy for Computer-assisted Reconstruction of Infrastructure Maxillary Defects Using Free Fibula Flap |
| title_full_unstemmed | Anatomical Landmark-guided Strategy for Computer-assisted Reconstruction of Infrastructure Maxillary Defects Using Free Fibula Flap |
| title_short | Anatomical Landmark-guided Strategy for Computer-assisted Reconstruction of Infrastructure Maxillary Defects Using Free Fibula Flap |
| title_sort | anatomical landmark guided strategy for computer assisted reconstruction of infrastructure maxillary defects using free fibula flap |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006626 |
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