Journal
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
Volume 37, Issue 11, Pages 1660-1664Publisher
WILEY
DOI: 10.1002/hed.23815
Keywords
mandible reconstruction; free fibula osteocutaneous flap; preoperative planning
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Funding
- NCI NIH HHS [P30 CA006927] Funding Source: Medline
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Background. Free fibula osteocutaneous flaps are the primary option for reconstruction after segmental mandibulectomies. This study evaluates the impact of CT-guided preoperative planning on operative outcomes after free fibula mandible reconstruction. Methods. We conducted a retrospective review of all patients undergoing free fibula reconstruction of the mandible from 2002 to 2011. Results. Fifty-seven patients underwent free fibula osteocutaneous flap reconstruction for head and neck cancers involving the mandible. Twelve patients had shaping of the neomandible performed on the back table while 20 patients underwent shaping in situ without the use of any adjunctive technology. The remaining 25 patients underwent preoperative CT imaging, which significantly decreased operative time (707 minutes vs 534 minutes; p < .0003) as well as overall costs ($24,532.50 vs $20,950.48). There were no significant differences in outcomes or complications. Conclusion. Preoperative, patient-specific CT modeling, and cutting guide fabrication outweigh the costs associated with the additional technology without jeopardizing overall outcomes or increasing complication rates. (C) 2014 Wiley Periodicals, Inc.
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