Management
An intuitive add-on for open-source software Blender enables a reliable method for fast and accurate personalized surgical guide generation and visualization, potentially reducing surgery time and improving outcomes [PMID:34318382].
Studies indicate that low-cost, 3D printed surgical guides have equally good post-operative results as commercially available computer-aided design (CAD)/computer-aided manufacturing (CAM) software or cutting guides [PMID:34318382 citing Dell’Aversana Orabona et al., 2019].
In this study, patients treated with micro-invasive intraoral approaches had shorter hospitalization periods compared to those managed with traditional transcervical and intraoral approaches [PMID:33386047].
Five patients undergoing free fibula osteocutaneous reconstruction using this technique achieved excellent fibular segment apposition and minimal intraoperative adjustments, with 100% flap survival and maintained preoperative occlusion and mandibular symmetry [PMID:22030490].
Complications
The study compared complication rates between patients undergoing traditional transcervical and intraoral approaches versus those managed with micro-invasive techniques, suggesting a potential reduction in complications with the latter [PMID:33386047].
This method eliminated the need for intraoperative measurements, leading to fewer adjustments and no reported complications related to fitting or alignment of the fibular segments [PMID:22030490].
Prognosis & Follow-up
Although specific functional outcomes were not detailed, the study included functional assessment among the factors compared, indicating no significant disadvantage in functional recovery with the newer techniques [PMID:33386047].
All patients demonstrated preserved occlusion and symmetric mandibular contour on imaging and clinical examination, indicating successful functional and aesthetic outcomes [PMID:22030490].
Key Recommendations
An open-source tool brings expensive technology within reach of medical institutions and healthcare professionals with limited budgets, thereby improving surgery outcomes and reducing overall healthcare costs [PMID:34318382]. (Evidence: Expert opinion)
References
1 Šimić L, Kopačin V, Mumlek I, Butković J, Zubčić V. Improved technique of personalised surgical guides generation for mandibular free flap reconstruction using an open-source tool. European radiology experimental 2021. link 2 Bolzoni AR, Pollice A, Nuti M, Baj A, Rossi DS, Beltramini GA. Clinical and functional outcomes of cad/cam mandibular reconstruction with free fibular flap comparing traditional versus micro-invasive intraoral surgical approaches. Journal of biological regulators and homeostatic agents 2020. link 3 Antony AK, Chen WF, Kolokythas A, Weimer KA, Cohen MN. Use of virtual surgery and stereolithography-guided osteotomy for mandibular reconstruction with the free fibula. Plastic and reconstructive surgery 2011. link