Methodology

Feasibility of preoperative planning using anatomical facsimile models for mandibular reconstruction

Corrado Toro¹ , Massimo Robiony^1* , Fabio Costa^1* , Nicoletta Zerman^2* and Massimo Politi^1*

¹  Department of Maxillofacial Surgery, University of Udine, Udine, Italy

²  Institute of Oral Pathology, University of Ferrara, Ferrara, Italy

author email corresponding author email* Contributed equally

Head & Face Medicine 2007, 3:5doi:10.1186/1746-160X-3-5

Published:	15 January 2007

Abstract

Background

Functional and aesthetic mandibular reconstruction after ablative tumor surgery continues to be a challenge even after the introduction of microvascular bone transfer. Complex microvascular reconstruction of the resection site requires accurate preoperative planning. In the recent past, bone graft and fixation plates had to be reshaped during the operation by trial and error, often a time-consuming procedure. This paper outlines the possibilities and advantages of the clinical application of anatomical facsimile models in the preoperative planning of complex mandibular reconstructions after tumor resections.

Methods

From 2003 to 2005, in the Department of Maxillofacial Surgery of the University of Udine, a protocol was applied with the preoperative realization of stereolithographic models for all the patients who underwent mandibular reconstruction with microvascular flaps. 24 stereolithographic models were realized prior to surgery before emimandibulectomy or segmental mandibulectomy. The titanium plates to be used for fixation were chosen and bent on the model preoperatively. The geometrical information of the virtual mandibular resections and of the stereolithographic models were used to choose the ideal flap and to contour the flap into an ideal neomandible when it was still pedicled before harvesting.

Results

Good functional and aesthetic results were achieved. The surgical time was decreased on average by about 1.5 hours compared to the same surgical kind of procedures performed, in the same institution by the same surgical team, without the aforesaid protocol of planning.

Conclusion

Producing virtual and stereolithographic models, and using them for preoperative planning substantially reduces operative time and difficulty of the operation during microvascular reconstruction of the mandible.