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New Technologies for Personalized Medicine in Head and Neck Surgery
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New Technologies for Personalized Medicine in Head and Neck Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: closed (10 June 2026) | Viewed by 2491

Editors

Prof. Dr. Carlos Navarro-Cuéllar

E-Mail Website
Guest Editor
1. Oral and Maxillofacial Surgery Department, Gregorio Marañón General University Hospital, Madrid, Spain
2. School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
Interests: head and neck oncology; microsurgery; head and neck reconstruction; dental implants; free flaps; orthognathic surgery; dental implants in oncologic patients; surgical treatment of sleep apnea
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. José Luis Cebríán-Carretero

E-Mail Website
Guest Editor
Oral and Maxillofacial Surgery Department, University Hospital La Paz, Universidad Autónoma de Madrid, 28046 Madrid, Spain
Interests: oral and maxillofacial surgery; dental implants; orthognathic surgery; oral cancer; facial reconstruction; facial trauma; dental bone regeneration
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Recent advances in biomedical engineering and digital health technologies have transformed the field of head and neck surgery, fostering a new era of precision and personalized medicine. The integration of high-resolution imaging, artificial intelligence, computer-assisted design and manufacturing (CAD/CAM), 3D printing, surgical navigation and patient-specific biomaterials enables individualized diagnosis, planning and treatment. In head and neck surgery, these tools are increasingly applied to a broad spectrum of conditions, including craniofacial malformations, maxillofacial trauma, orthognathic deformities, temporomandibular joint disorders, benign and malignant tumors, reconstructive surgery and implant-based rehabilitation. Moreover, advances in genomics, proteomics and tissue engineering contribute to tailored therapeutic strategies, particularly in oncologic and regenerative applications. This Special Issue, “New Technologies for Personalized Medicine in Head and Neck Surgery,” welcomes original research, clinical studies and comprehensive reviews that explore emerging technologies, translational approaches and multidisciplinary collaborations bridging surgery, biomedical engineering and data science. By integrating technological innovation with clinical expertise, this issue aims to define the future paradigm of patient-specific care in head and neck surgery, enhancing precision, safety and functional as well as aesthetic outcomes.

Prof. Dr. Carlos Navarro-Cuéllar
Prof. Dr. José Luis Cebríán-Carretero
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • personalized medicine
  • head and neck surgery
  • 3D printing
  • surgical navigation
  • artificial intelligence
  • computer-assisted surgery
  • regenerative medicine
  • precision oncology
  • craniofacial reconstruction
  • biomaterials
  • virtual surgical planning
  • genomics and proteomics
  • tissue engineering
  • functional rehabilitation

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Published Papers (4 papers)

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Research

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15 pages, 3080 KB  
Article
Beyond Accuracy: Perioperative Efficiency and Institutional Cost Implications of CAD/CAM-Guided Versus Conventional Freehand Fibula Free Flap Reconstruction for Mandibular and Maxillary Defects
by Borja González Moure, Saad Khayat, Diego Fernández Acosta, Ignacio Navarro Cuéllar, Cristina Maza Muela, Ana López López, Manuel Tousidonis Rial, Gema Arenas de Frutos, Carlos Martínez Martínez, Raúl Antúnez-Conde, Stefania Troise, Luigi Angelo Vaira, Giovanni Dell’Aversana Orabona, Santiago Ochandiano, Francisco Javier López de Atalaya, José Ignacio Salmerón and Carlos Navarro Cuéllar
J. Clin. Med. 2026, 15(5), 1778; https://doi.org/10.3390/jcm15051778 - 26 Feb 2026
Cited by 2 | Viewed by 627
Abstract
Background: Computer-aided design and manufacturing (CAD/CAM) technology has been increasingly adopted for mandibular and maxillary reconstruction using fibula free flaps. However, its clinical and economic advantages over the conventional freehand technique remain debated. The objective of this study was to compare perioperative outcomes [...] Read more.
Background: Computer-aided design and manufacturing (CAD/CAM) technology has been increasingly adopted for mandibular and maxillary reconstruction using fibula free flaps. However, its clinical and economic advantages over the conventional freehand technique remain debated. The objective of this study was to compare perioperative outcomes and institutional costs between CAD/CAM-guided and conventional freehand fibula flap reconstructions. Methods: An ambispective observational study was conducted including patients who underwent mandibular or maxillary reconstruction with an osteocutaneous free fibula flap between 2017 and 2024. Reconstructions were performed either using CAD/CAM-guided virtual surgical planning or the conventional freehand technique. Demographic data, perioperative variables, postoperative outcomes, oncologic margin status, transfusion requirements, and total institutional costs were analyzed. Univariate comparisons were performed between groups, and multivariate linear regression models were used to assess the independent association of CAD/CAM guidance with operative time and hospital length of stay. Results: Fifty-one patients were included (25 CAD/CAM-guided and 26 freehand). CAD/CAM-guided reconstruction was associated with a significantly shorter operative time (542.3 ± 65.8 vs. 604.9 ± 79.5 min; p = 0.0036) and a shorter overall hospital stay (19.6 ± 7.2 vs. 30.6 ± 26.2 days; p = 0.047) in univariate analysis. The need for perioperative blood transfusion was significantly lower in the CAD/CAM group. No significant differences were observed in ICU stay, flap failure, reintervention rate, or postoperative hemoglobin decrease. Although margin status did not differ significantly between groups, a higher proportion of negative margins was observed in the CAD/CAM cohort. In multivariate analysis adjusting for age and perioperative variables, CAD/CAM guidance remained independently associated with reduced operative time, but not with hospital length of stay. Despite higher upfront planning costs, total per-patient cost was lower in the CAD/CAM group due to improved perioperative efficiency. Conclusions: CAD/CAM-guided fibula free flap reconstruction is a safe and effective technique that is associated with reduced operative time and lower transfusion requirements while maintaining comparable oncologic outcomes. When perioperative efficiency gains are achieved, these advantages may offset the higher planning costs, resulting in overall cost savings at the institutional level. CAD/CAM-assisted reconstruction may therefore be particularly advantageous in high-volume oncologic centers and anatomically complex cases. Full article
(This article belongs to the Special Issue New Technologies for Personalized Medicine in Head and Neck Surgery)
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Review

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23 pages, 4897 KB  
Review
Maintenance of Custom-Made Subperiosteal Implants: A Narrative Review of Indirect Evidence and Preliminary Clinical Considerations
by Valentina Dessì and Luigi Angelo Vaira
J. Clin. Med. 2026, 15(11), 4333; https://doi.org/10.3390/jcm15114333 - 3 Jun 2026
Cited by 2 | Viewed by 386
Abstract
Background: Custom-made subperiosteal implants have re-emerged as a valuable option for the rehabilitation of patients with severe maxillofacial atrophy and post-oncological defects. Despite advances in digital workflows and implant design, their unique anatomical, biological, and prosthetic characteristics pose specific challenges for long-term maintenance, [...] Read more.
Background: Custom-made subperiosteal implants have re-emerged as a valuable option for the rehabilitation of patients with severe maxillofacial atrophy and post-oncological defects. Despite advances in digital workflows and implant design, their unique anatomical, biological, and prosthetic characteristics pose specific challenges for long-term maintenance, and no dedicated standardized guidelines are currently available. Methods: This narrative review critically appraises the available literature on implant maintenance and related fields. A comprehensive search was conducted across PubMed, Scopus, and Web of Science, including studies on peri-implant maintenance, supportive periodontal therapy, full-arch and zygomatic implant rehabilitations, and subperiosteal implants. Due to the lack of direct evidence, a qualitative narrative synthesis was adopted to develop preliminary clinical considerations for maintenance of custom-made subperiosteal implants. These considerations should be interpreted as an expert-informed perspective rather than validated clinical guidelines. Results: Conventional maintenance protocols developed for endosseous implants are not directly transferable to subperiosteal implants due to differences in the implant–tissue interface, biomechanics, diagnostic parameters, and hygiene accessibility. Key challenges include the absence of a conventional peri-implant sulcus, possible implant exposure, complex prosthetic geometries, and potential susceptibility to biofilm accumulation in areas with limited access. Evidence from related fields highlights the importance of structured maintenance, individualized risk-based follow-up, effective biofilm control, and patient-specific home-care strategies. Conclusions: Preliminary evidence-informed clinical considerations for the maintenance of subperiosteal implants are proposed, with emphasis on plaque control, individualized follow-up, descriptive clinical monitoring, and hygiene-oriented prosthetic and surgical planning. These considerations are not intended as validated guidelines, but as a practical starting point for clinical reasoning in an area where dedicated evidence remains limited. Full article
(This article belongs to the Special Issue New Technologies for Personalized Medicine in Head and Neck Surgery)
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Other

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12 pages, 1275 KB  
Systematic Review
Management of the Clinically N0 Neck in Maxillary Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis
by Fabio Maglitto, Giovanni Salzano, Serena Trotta, Eutilia Manzo, Luigi Angelo Vaira, Umberto Committeri, Stefania Troise and Giovanni Dell’Aversana Orabona
J. Clin. Med. 2026, 15(11), 4310; https://doi.org/10.3390/jcm15114310 - 2 Jun 2026
Viewed by 406
Abstract
Background: The optimal management of the clinically node-negative (cN0) neck in maxillary squamous cell carcinoma (MSCC) remains controversial due to the relatively low yet clinically relevant risk of occult cervical metastasis. While elective neck dissection (END) has been proposed to improve oncologic outcomes, [...] Read more.
Background: The optimal management of the clinically node-negative (cN0) neck in maxillary squamous cell carcinoma (MSCC) remains controversial due to the relatively low yet clinically relevant risk of occult cervical metastasis. While elective neck dissection (END) has been proposed to improve oncologic outcomes, others advocate observation to avoid overtreatment. This study aimed to evaluate the impact of END versus observation on overall survival (OS) in cN0 MSCC patients. Methods: A systematic literature search was conducted in PubMed, Embase, and Scopus according to the PRISMA 2020 statement. The protocol was registered in PROSPERO (CRD420261345038). Studies including patients with maxillary SCC and clinically N0 neck comparing END with observation were eligible. Fourteen studies were included in the qualitative synthesis, and five were suitable for quantitative meta-analysis. The primary endpoint was OS. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Risk of bias was assessed using ROBINS-I, and certainty of evidence was evaluated using the GRADE framework. Results: The meta-analysis demonstrated a statistically significant survival benefit associated with END. The pooled HR for OS was 0.76 (95% CI 0.67–0.86; p < 0.001), indicating a 24% relative reduction in the hazard of death compared with observation. Importantly, statistical heterogeneity was negligible (I2 = 0%), although interpretation should be cautious given the limited number of included studies. Despite this, most included studies were retrospective in design. Conclusions: END appears to provide a survival advantage in selected patients with cN0 MSCC. However, the evidence is largely derived from retrospective data. High-quality prospective multicenter studies are needed to better define the role of elective neck management in this population. Full article
(This article belongs to the Special Issue New Technologies for Personalized Medicine in Head and Neck Surgery)
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Graphical abstract

30 pages, 1668 KB  
Systematic Review
Nasal Epithelial Organoids as Translational Platforms in Inflammatory, Infectious, and Precision Medicine Applications: A Systematic Review
by Veronica Scocca, Lorenzo Lauda, Riccardo Nocini and Giovanni Dell'Aversana Orabona
J. Clin. Med. 2026, 15(11), 4016; https://doi.org/10.3390/jcm15114016 - 22 May 2026
Viewed by 607
Abstract
Background/Objectives: The airway epithelium plays a central role in host defense, inflammatory signaling, and disease progression across infectious, inflammatory, and genetic respiratory disorders. Human nasal epithelial organoids have emerged as accessible and patient-specific in vitro platforms with increasing translational relevance. This systematic review [...] Read more.
Background/Objectives: The airway epithelium plays a central role in host defense, inflammatory signaling, and disease progression across infectious, inflammatory, and genetic respiratory disorders. Human nasal epithelial organoids have emerged as accessible and patient-specific in vitro platforms with increasing translational relevance. This systematic review aimed to critically evaluate the current evidence on nasal epithelial organoid models, focusing on donor characteristics, culture methodologies, differentiation strategies, and translational applications. Methods: A systematic search of PubMed/MEDLINE, Embase, Scopus, Ovid MEDLINE, and Cochrane Library was conducted for studies published between 1990 and April 2026. The review followed PRISMA guidelines and was structured according to the PICOTS framework. Eligible studies included in vitro experimental investigations using human-derived nasal epithelial organoids in infectious, inflammatory, or precision medicine contexts. Risk of bias was assessed using the QUIN tool. Results: Seventeen studies met the inclusion criteria. Applications clustered into three principal domains: infectious disease modeling, inflammatory and epithelial remodeling research, and cystic fibrosis precision medicine. Most studies employed expandable three-dimensional Matrigel-embedded organoids or organoid-derived air–liquid interface systems. Infection-focused studies demonstrated variant-specific viral replication dynamics and epithelial immune responses, while inflammatory models reproduced disease-associated differentiation and remodeling phenotypes. Cystic fibrosis oriented studies showed that organoid swelling and electrophysiological assays correlate with CFTR functional rescue and, in selected cases, clinical response. Methodological heterogeneity across protocols and outcome reporting precluded quantitative synthesis. Conclusions: Human nasal epithelial organoids represent versatile translational platforms bridging accessible patient-derived tissue and advanced airway disease modeling. Although variability in culture protocols and functional benchmarks limits standardization, these models hold significant promise for mechanistic investigation, therapeutic stratification, and precision medicine applications. Full article
(This article belongs to the Special Issue New Technologies for Personalized Medicine in Head and Neck Surgery)
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