Application of computer-assisted design and three-dimensional printing technique in reconstruction of maxillary defects with individual free fibular flap
10.3760/cma.j.issn.1673-0860.2020.03.004
- VernacularTitle:3D打印辅助设计个性化游离腓骨瓣成形修复上颌骨切除术后缺损
- Author:
Shizhi HE
1
;
Luo ZHANG
;
Jugao FANG
;
Qi ZHONG
;
Yunxia LI
;
Qian SHI
;
Yang ZHANG
;
Hongzhi MA
;
Pingdong LI
;
Lizhen HOU
;
Xiaohong CHEN
Author Information
1. 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科 100730
- Keywords:
Maxilla;
Fibula;
Myocutaneous flap;
3D printing;
Reconstructive surgical procedures
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2020;55(3):205-208
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the application of computer-assisted design and three-dimensional printing technique in reconstruction of maxillary defects with individual free fibular flap.Methods:A total of 13 patients, 7 males and 6 females with age from 12 to 55 years old, underwent the reconstruction of maxillary defects after subtotal or total maxillectomy for benign or malignant tumors between January 2016 and December 2018 were reviewed. Ther were 4 cases of subtotal maxillectomy and 9 cases of total maxillectomy. Before operation, osteotomy line was planned on three-dimensional images. A three-dimensional individual resin fibula model based on mirror images of the healthy side maxilla was obtained to fabricate an anatomically adapted osteomyocutaneous fibula free flap using computer-assisted design and forming. Oral, nasal, and eye functions and facial appearance were evaluated.Results:The 13 cases were followed up for 5-40 months, all flaps were alive except one due to flap failure and all cases were tumor free confirmed by CT or MRI. Ten patients could eat normal food without nasal food return, and 3 cases had palatal fistula. Eleven cases showed good speaking functional results. All cases had normal eye positions, no cases with diplopia and loss of vision. With evaluation by VAS, an average score of 8 was obtained, and most of patients were satisfied with their postoperative facial appearances.Conclusion:Reconstruction of maxillary defects by free fibular flap designed by three-dimensional printing and computer-assisted technique not only restored oral, nasal and eye functions, but also showed satisfactory facial appearance.
