Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template

Tatti, Melania; Carta, Filippo; Bontempi, Mauro; Deriu, Sara; Mariani, Cinzia; Marrosu, Valeria; Foddis, Emanuele; Gerosa, Clara; Marongiu, Giuseppe; Saba, Luca; Figus, Andrea; Pau, Massimiliano; Leban, Bruno; Puxeddu, Roberto

doi:10.3390/jpm14050512

Open AccessArticle

Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template

by

Melania Tatti

^1,†,

Filippo Carta

^1,*,†

,

Mauro Bontempi

¹,

Sara Deriu

¹,

Cinzia Mariani

¹

,

Valeria Marrosu

¹,

Emanuele Foddis

¹,

Clara Gerosa

²,

Giuseppe Marongiu

³

,

Luca Saba

⁴

,

Andrea Figus

⁵,

Massimiliano Pau

⁶

,

Bruno Leban

⁶

and

Roberto Puxeddu

^1,7

¹

Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy

²

Unit of Pathology, Department of Medical Sciences and Public Health, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy

³

Unit of Orthopedics and Traumatology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy

⁴

Department of Science of the Images, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy

⁵

Unit of Plastic Surgery, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy

⁶

Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy

⁷

Unit of Otorhinolaryngology, King’s College Hospital London-Dubai, Dubai P.O. Box 340901, United Arab Emirates

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

J. Pers. Med. 2024, 14(5), 512; https://doi.org/10.3390/jpm14050512

Submission received: 22 March 2024 / Revised: 2 May 2024 / Accepted: 7 May 2024 / Published: 11 May 2024

(This article belongs to the Special Issue Head and Neck Oncologic Surgery: Clinical Updates and New Perspectives in Precision Medicine Era)

Download

Browse Figure

Versions Notes

Abstract

Introduction: The present study evaluates the influence of virtual surgical planning with a preoperative 3D resin model on aesthetic and functional outcomes in patients treated by segmental mandibulectomy and reconstruction with fibula-free flap for oral cancer. Methods: All consecutive patients who underwent segmental mandibulectomy and mandibular reconstruction with a fibula-free flap using a 3D template at our department from January 2021 to January 2023 were included in the study. “Patients control” were patients treated by reconstruction with a fibula-free flap without using a 3D template. Three-dimensional modeling was performed by converting from preoperative computed tomography to a stereolithography format to obtain the resin 3D models. Qualitative analysis of anatomical and aesthetic results consisted of the evaluation of the patients’ aesthetic and functional satisfaction and the symmetry of the mandibular contour observed at clinical examination. Quantitative analysis was based on the assessment of the accuracy and precision of the reconstruction by comparing preoperative and postoperative computed tomograms as objective indicators. Results: Seven patients (five males and two females, mean age of 65.1 years) were included in the study. All patients showed a symmetric mandibular contour based on the clinical examination. After recovery, six patients (85.7%) considered themselves aesthetically satisfied. The quantitative analysis (assessed in six/seven patients) showed that the mean difference between preoperative and postoperative intercondylar distance, intergonial angle distance, anteroposterior dimension, and gonial angle improved in the 3D template-assisted group. Conclusion: The 3D-printed template for mandibular reconstruction with microvascular fibula-free flap can improve aesthetic outcomes in comparison with standard approaches.

Keywords: mandibular reconstruction; free flap; 3D reconstruction; oral cancer

Share and Cite

MDPI and ACS Style

Tatti, M.; Carta, F.; Bontempi, M.; Deriu, S.; Mariani, C.; Marrosu, V.; Foddis, E.; Gerosa, C.; Marongiu, G.; Saba, L.; et al. Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template. J. Pers. Med. 2024, 14, 512. https://doi.org/10.3390/jpm14050512

AMA Style

Tatti M, Carta F, Bontempi M, Deriu S, Mariani C, Marrosu V, Foddis E, Gerosa C, Marongiu G, Saba L, et al. Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template. Journal of Personalized Medicine. 2024; 14(5):512. https://doi.org/10.3390/jpm14050512

Chicago/Turabian Style

Tatti, Melania, Filippo Carta, Mauro Bontempi, Sara Deriu, Cinzia Mariani, Valeria Marrosu, Emanuele Foddis, Clara Gerosa, Giuseppe Marongiu, Luca Saba, and et al. 2024. "Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template" Journal of Personalized Medicine 14, no. 5: 512. https://doi.org/10.3390/jpm14050512

APA Style

Tatti, M., Carta, F., Bontempi, M., Deriu, S., Mariani, C., Marrosu, V., Foddis, E., Gerosa, C., Marongiu, G., Saba, L., Figus, A., Pau, M., Leban, B., & Puxeddu, R. (2024). Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template. Journal of Personalized Medicine, 14(5), 512. https://doi.org/10.3390/jpm14050512

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Menu

Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template

Abstract

Share and Cite

Article Metrics

Article Access Statistics

Further Information

Guidelines

MDPI Initiatives

Follow MDPI