Improving the accuracy of mandibular reconstruction with vascularized iliac crest flap: Role of computer-assisted techniques

2016 ◽  
Vol 44 (11) ◽  
pp. 1819-1827 ◽  
Author(s):  
Wen-Bo Zhang ◽  
Yao Yu ◽  
Yang Wang ◽  
Chi Mao ◽  
Xiao-Jing Liu ◽  
...  
Keyword(s):  
Iliac Crest ◽  
Mandibular Reconstruction ◽  
Computer Assisted ◽  
Iliac Crest Flap

Current role of the iliac crest flap in mandibular reconstruction

Microsurgery ◽  
2011 ◽  
Vol 31 (8) ◽  
pp. 616-619 ◽  
Author(s):  
Shimpei Miyamoto ◽  
Minoru Sakuraba ◽  
Shogo Nagamatsu ◽  
Ryuichi Hayashi
Keyword(s):  
Iliac Crest ◽  
Mandibular Reconstruction ◽  
Current Role ◽  
Iliac Crest Flap

scholarly journals Comparison of Complicated and Simple Guiding Templates in Mandibular Reconstruction Using Vascularized Iliac Crest Flap

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Mei Zho ◽  
Zhe Shao ◽  
Yuxi Zhu ◽  
Bing Liu ◽  
Tianfu Wu
Keyword(s):  
Iliac Crest ◽  
Operation Time ◽  
Mandibular Reconstruction ◽  
Height Loss ◽  
Virtual Surgery ◽  
Intraoperative Procedures ◽  
Iliac Crest Flap ◽  
Mandibular Defect ◽  
Reconstruction Strategy ◽  
Graft Success

Objective. This study aims to compare the degree of accuracy achieved in mandibular reconstruction between complicated guiding templates (CGT) and simple guiding templates (SGT), to evaluate the necessity to spend more time to design complicated templates prior to surgery. Methods. The preoperative virtual surgery plan (VSP) was used to simulate the osteotomy and accurate mandibular reconstruction strategy. Then the guiding templates were designed and printed to transfer the VSP into the real operation. Between July 2013 and November 2014, we used the SGT in 13 L-type mandibular defect reconstructions utilising vascularized iliac crest bone (VICB). From March 2015 to March 2018, we used CGT in 14 L-type mandibular defects, also reconstructing with VICB. The indicators of mandibular symmetry, midline deviation, alveolar height loss, bone conjunction gap, and operation time were analyzed and compared between the two groups. Results. The overall bone graft success rate was 100% (27/27) between all patients. The SGT and CGT groups showed similar symmetry (1.01 ± 0.03 vs. 1.03 ± 0.04, P = 0.11) and mandibular midline displacement (1.0 ± 0.7 mm vs. 1.2 ± 0.8 mm, P=0.29). The CGT group showed less alveolar height deficiency than the SGT group (3.0 ± 2.4 mm vs. 7.8 ± 6.8 mm, P=0.01) and lesser bony conjunction gap between the graft and the mandible (1.6 ± 0.7 mm vs. 2.4 ± 1.2 mm, P = 0.02). The average operation time was significantly lower in the CGT group than in the SGT group (340.5 ± 74 min vs. 391.9 ± 41.7 min, P = 0.02). Conclusion. In the simple mandibular reconstruction, the time-consuming CGT did not significantly improve the symmetry and midline displacement compared to SGT, but it demonstrated less reduction (increased preservation) in alveolar height and decreased the size of the bone conjunction gap. And in addition, CGT also reduced the average operation time and simplified intraoperative procedures compared with SGT.

Double-Barrel Fibula Flap Versus Vascularized Iliac Crest Flap for Mandibular Reconstruction

2020 ◽  
Vol 78 (5) ◽  
pp. 844-850 ◽  
Author(s):  
Yao Yu ◽  
Wen-Bo Zhang ◽  
Xiao-Jing Liu ◽  
Chuan-Bin Guo ◽  
Guang-Yan Yu ◽  
...  
Keyword(s):  
Iliac Crest ◽  
Mandibular Reconstruction ◽  
Iliac Crest Flap ◽  
Fibula Flap

The Evolution of the Iliac Crest Flap

2019 ◽  
pp. 449-454
Author(s):  
Peirong Yu ◽  
Mark V. Schaverien
Keyword(s):  
Iliac Crest ◽  
Donor Site ◽  
Surgical Techniques ◽  
Perforator Flap ◽  
Donor Site Morbidity ◽  
Postoperative Management ◽  
Mandibular Reconstruction ◽  
Thigh Muscle ◽  
Iliac Crest Flap ◽  
The Many

The iliac crest free flap, although the gold standard for many years for mandibular reconstruction, remains an important option in the armamentarium for mandibular reconstruction. With the increasing popularity of the fibula osteocutaneous flap, which allows for more refined reconstruction and permits multiple osteotomies, the iliac crest flap is typically reserved for where the fibula flap is contraindicated, including in those with peripheral vascular disease, peroneal magnum, history of fibula fractures, and with previous bilateral fibular flaps. The many limitations of the traditional osteomusculocutaneous flap have been overcome by modified approaches to harvest, including the split iliac crest based on the inner cortex to preserve the thigh muscle attachments and reduce donor site morbidity, and the deep circumflex iliac artery perforator flap that does not include the bulky abdominal wall musculature and allows greater freedom of movement of the skin paddle. This chapter reviews the indications, anatomy, surgical techniques, and postoperative management for the free iliac crest flap.

scholarly journals Rekonstruksi defek mandibula menggunakan jabir bebas fibula

2015 ◽  
Vol 44 (2) ◽  
pp. 146
Author(s):  
Dini Widiarni ◽  
Indah Saraswati
Keyword(s):  
Iliac Crest ◽  
Microvascular Surgery ◽  
Mandibular Reconstruction ◽  
Free Fibular Flap ◽  
Iliac Crest Flap ◽  
Facial Defects ◽  
Fibular Flap ◽  
The Right ◽  
Oromandibular Reconstruction ◽  
Scapula Flap

Latar belakang: Perkembangan teknik pembedahan mikrovaskular telah menghasilkan jabir bebas fibula yang dapat digunakan untuk rekonstruksi oromandibular.  Jabir bebas fibula merupakan salah satu jabir tulang yang sering digunakan untuk mengatasi defek pada daerah wajah, terutama dalam rekonstruksi mandibula. Jabir ini memiliki banyak keunggulan dibandingkan dengan jabir tulang lainnya, seperti jabir skapula dan jabir iliaka. Jabir ini memiliki angka kesuksesan yang cukup tinggi yaitu mencapai 95%, namun untuk mencapai angka keberhasilan tersebut diperlukan perencanaan yang tepat sebelum dilakukannya pengambilan jabir mulai dari preoperatif, perioperatif, intraoperatif, dan pascaoperatif. Tujuan: Para ahli THT dapat mengetahui perencanaan yang tepat sebelum melakukan rekonstruksi mandibula. Tinjauan pustaka: Jabir bebas fibula memiliki angka keberhasilan yang tinggi dan merupakan jabir pilihan untukrekonstruksi mandibula. Kesimpulan: Perencanaan yang tepat mulai dari preoperatif sampai pascaoperatif sebelum dilakukan pengambilan jabir bebas fibula sangat diperlukan untuk mendapatkan hasil yang optimal.Kata kunci: Jabir bebas fibula, pembedahan mikrovaskular, rekonstruksi mandibula ABSTRACTBackground: Development in microvascular surgery technique has created a flap that can be used for oromandibular reconstruction. Free fibular flap is one of the bone flaps that frequently use for facial defects, especially mandibular reconstruction. This flap has lots of advantages than other bone flaps, such as scapula flap and iliac crest flap. Free fibular flap has a high successful rate up to 95%, but it needs meticulous planning before harvesting the bone; preoperative, perioperative, intraoperative, and postoperative is needed to get the high successful rate. Purpose: To inform ENT specialists about the appropriate planning before mandibular reconstruction. Literature review: Free fibular flap has a high successful rate and one of the excellent choices for mandibular reconstruction. Conclusion: The right preoperative to postoperative planning before doing the free fibularflap is very important to obtain optimal outcome. Keywords: Free fibular flap, microvascular surgery, mandibular reconstruction

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