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Reconstruction of extensive mandibular defects using deep circumflex iliac artery flap surgery and 3D-printed guides: a case report

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초록

This case report describes mandibular reconstruction using a deep circumflex iliac artery (DCIA) flap, incorporating virtual surgical planning and 3D-printed surgical guides, following tumor resection. A 49-year-old male presented with an ulcerative lesion in the left posterior mandible. Following a diagnosis of squamous cell carcinoma (pT4aN2bM0), selective neck dissection (level I–IV) and segmental mandibulectomy were performed. Virtual surgical planning based on computed tomography images enabled the creation of patient-specific surgical guides. Reconstruction of the mandible and soft tissue was achieved using a DCIA flap that included the internal oblique muscle. The procedure lasted 605 minutes, with an ischemia time of 43 minutes. During a one-year follow-up, no complications or recurrences occurred, and functional and aesthetic outcomes were satisfactory. DCIA flap reconstruction with virtual surgical planning and custom surgical guides demonstrates effectiveness as a treatment for extensive mandibular defects.

Abstract

This case report describes mandibular reconstruction using a deep circumflex iliac artery (DCIA) flap, incorporating virtual surgical planning and 3D-printed surgical guides, following tumor resection. A 49-year-old male presented with an ulcerative lesion in the left posterior mandible. Following a diagnosis of squamous cell carcinoma (pT4aN2bM0), selective neck dissection (level I–IV) and segmental mandibulectomy were performed. Virtual surgical planning based on computed tomography images enabled the creation of patient-specific surgical guides. Reconstruction of the mandible and soft tissue was achieved using a DCIA flap that included the internal oblique muscle. The procedure lasted 605 minutes, with an ischemia time of 43 minutes. During a one-year follow-up, no complications or recurrences occurred, and functional and aesthetic outcomes were satisfactory. DCIA flap reconstruction with virtual surgical planning and custom surgical guides demonstrates effectiveness as a treatment for extensive mandibular defects.

참고문헌 (21)

  1. Lawson W, "Experience with immediate and delayed mandibular reconstruction", Laryngoscope, 92, pp.5~10 (1982)[DOI]
  2. Kumar BP, "Mandibular reconstruction : overview", J Maxillofac Oral Surg, 15, pp.425~441 (2016)[DOI]
  3. Lonie S, "Mandibular reconstruction : meta-analysis of iliac-versus fibula-free flaps", ANZ J Surg, 86, pp.337~342 (2016)[DOI]
  4. Bak M, "Contemporary reconstruction of the mandible", Oral Oncol, 46, pp.71~76 (2010)[DOI]
  5. Maurer P, "Scope and limitations of methods of mandibular reconstruction : a long-term follow-up", Br J Oral Maxillofac Surg, 48, pp.100~104 (2010)[DOI]
  6. Taylor GI, "Superiority of the deep circumflex iliac vessels as the supply for free groin flaps", Plast Reconstr Surg, 64, pp.595~604 (1979)
  7. Wilde F, "Computer-assisted mandibular reconstruction using a patient-specific reconstruction plate fabricated with computer-aided design and manufacturing techniques", Craniomaxillofac Trauma Reconstr, 7, pp.158~166 (2014)[DOI]
  8. Hirsch DL, "Use of computer-aided design and computer-aided manufacturing to produce orthognathically ideal surgical outcomes : a paradigm shift in head and neck reconstruction", J Oral Maxillofac Surg, 67, pp.2115~2122 (2009)[DOI]
  9. Kirke DN, "Using 3D computer planning for complex reconstruction of mandibular defects", Cancers Head Neck, 1, pp.17~ (2016)[DOI]
  10. Yu Y, "A new procedure assisted by digital techniques for secondary mandibular reconstruction with free fibula flap", J Craniofac Surg, 27, pp.2009~2014 (2016)[DOI]
  11. Zhang L, "Evaluation of computer-assisted mandibular reconstruction with vascularized fibular flap compared to conventional surgery", Oral Surg Oral Med Oral Pathol Oral Radiol, 121, pp.139~148 (2016)[DOI]
  12. Bosc R, "Mandibular reconstruction after cancer : an in-house approach to manufacturing cutting guides", Int J Oral Maxillofac Surg, 46, pp.24~31 (2017)[DOI]
  13. Han HH, "The pros and cons of computeraided surgery for segmental mandibular reconstruction after oncological surgery", Arch Craniofac Surg, 18, pp.149~154 (2017)[DOI]
  14. Moiduddin K, "Computer assisted design and analysis of customized porous plate for mandibular reconstruction", IRBM, 38, pp.78~89 (2017)[DOI]
  15. Kim HS, "Anatomical basis of the deep circumflex iliac artery flap", J Craniofac Surg, 24, pp.605~609 (2013)[DOI]
  16. Bissinger O, "Minimally-invasive deep circumflex iliac artery flap without crest, spine and skin to reconstruct composite defects of the mandible using virtual surgical planning and computer-aided design", computer-aided manufacturing technology, 2024, pp.52(Suppl 2), 71~
  17. Shan X, "One-stage mandibular reconstruction with free iliac flap and immediate implant-supported prosthesis", Int J Oral Maxillofac Surg, 52(Suppl 2), pp.85~86 (2024)[DOI]
  18. Kang YF, "Onestage jaw reconstruction and prosthetic rehabilitation with an iliac flap : a case report and literature review", Maxillofac Plast Reconstr Surg, 46, pp.3~ (2024)[DOI]
  19. Succo G, "Step-by-step surgical technique for mandibular reconstruction with fibular free flap : application of digital technology in virtual surgical planning", Eur Arch Otorhinolaryngol, 272, pp.1491~1501 (2015)[DOI]
  20. Sozzi D, "Surgical navigation in mandibular reconstruction : accuracy evaluation of an innovative protocol", J Clin Med, 11, pp.2060~ (2022)[DOI]
  21. Shao L, "Robot-assisted augmented reality surgical navigation based on optical tracking for mandibular reconstruction surgery", Med Phys, 51, pp.363~377 (2024)[DOI]

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