Summary
Objective
To analyze a novel technique of supporting fibula free flap harvest and fabrication
with intraoperative navigation technology.
Materials and methods
In the first phase of the study, navigation accuracy achieved with two registration
methods, namely, point-pair and hybrid technique utilizing point-pair with surface
matching, were evaluated in the form of the fiducial (FRE) and target registration
error (TRE). Next, a series of 42 simulated navigated fibular osteotomies were conducted
on specially manufactured lower leg phantom. Postoperative results were analyzed in
the form of the angular and position deviations between the virtually planned and
the obtained osteotomies.
Results
Mean FRE values obtained with point-pair and hybrid registration methods were 1.82 ±
0.96 mm and 1.41 ± 0.44 mm, respectively. Mean TRE value in the fibula region was
2.00 ± 0.67 mm for the first method and 1.51 ± 0.72 mm for the second. For all performed
surgeries, the total mean angular deviation between the planned and actual osteotomy
trajectory equaled 3.66° ± 3.60°. The total mean position disparity of osteotomy control
points was 1.85 ± 0.99 mm.
Conclusions
Navigation-guided free fibula flap harvest and fabrication, due to encouraging study
results and its superiority over currently popular cutting guides in many clinical
aspects, may become a routine operative procedure for the reconstruction of complex
mandibular defects. The presented method is especially well suited for plastic and
maxillofacial surgery.
Keywords
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Article info
Publication history
Published online: February 08, 2019
Accepted:
January 18,
2019
Received:
August 23,
2018
Identification
Copyright
© 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
