Article
Virtual planning of complex head and neck reconstructions – satisfactory match between real outcomes and virtual models
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Published: | December 20, 2013 |
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Outline
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Purpose: The reconstruction of large facial bony defects using microvascular transplants requires extensive surgery to achieve full rehabilitation of form and function. This retrospective study evaluates the virtual planning tool ProPlan CMF®in 30 consecutive cases to enhance precision and efficiency of the reconstructions.
Methods: Thirty patients with virtual planned immediate or secondary microvascular reconstructions of bony and soft tissue defects of the mandible and maxilla were acquired for this study. The virtual planning was done using ProPlan CMF®(Materialise NV, Leuven, Belgium). Based on a preoperative CBCT or CT scan of the defect and donor site, the resection and osteotomies were virtually planned. Patient specific plates were pre-bent according to planned outcome models. Postoperatively, a CBCT scan was used to access the accuracy and precision of the acquired results in comparison to the virtual planned outcome.
Results: 63 bone segments were transplanted. In average, the deviations between the virtual planning and the postoperative situation were for the defect sizes +1.17 mm,for the resection planes +/–1.69 mmand 10.16°and for the planes of the donor segments10.81°. The orientation of the segments differed by 6.68°from the virtual plan, the length of the segments differed by –0.12 mmand +0.17%, respectively, while the volume differed by –31.02%. The distance between the transplanted segments and the remaining bone were +/– 1.49 mmand between the segments +/– 1.49 mm.
Conclusions: ProPlan CMF®is a reliable and precise tool for virtual planning of microvascular bony reconstructions in the head and neck.