The Application Of Modified Digital Surgical Guide System In Mandibular Reconstruction With A Fibula Flap

Objective:To evaluate the effects of the three-dimensional virtual planning and the application of modified digital guide system in precise mandibular reconstruction with a fibula flap.Methods:This article Retrospectively reviewed 26 patients who underwent mandibular construction with a free fibula flap during February 2014 to November 2018.They were divided into three groups in the light of types of surgical methods.8 patients in Group A underwent reconstruction by using modified digital guide system.11 patients in Group B underwent reconstruction by using conventional guide system.7 patients in Group C underwent surgery on the basis of surgeon’s experience.All the cases were evaluated in many ways,such as the total operation time,ischemia time of the fibula flaps,accuracy of surgery and postoperative complications.Results:All flaps survived.The operation time of Group A(430.33±37.21 min)and Group B(462.25±37.18 min)was shorter than Group C(634.52±49.73 min)(P<0.05);There is no significant difference between the operation time of Group A and Group B;The ischemia time of Group A(69.84±6.84 min)is shorter than Group B(103.75±9.75 min),and they both were shorter than Group C(158.48±11.71 min)(P<0.05);The average gonion and condyle shift of Group A was smaller than those of group B and C(P<0.05).Conclusion:The application of modified digital guide system in mandibular reconstruction with a fibula flap can shorten the total operation time and ischemia time of flaps,improve the accuracy of reconstruction,which is a precise and reliable technique.