Comparing the Complexity of Mandibular Reconstruction Using Virtual Surgical Planning vs Traditional Methods

Sunday, September 29, 2024

8:12 AM – 8:18 AM EDT

Location: MBCC, 208

Disclosure(s):

Ian L. Sunyecz, DO:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Adam S. Howard, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Parker H. Tumlin, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Use of virtual surgical planning (VSP) in head and neck surgeries may allow for more complex reconstructions while also shortening operative times. However, the literature discussing this topic is limited. This study aims to identify if there is a difference in reconstruction complexity for mandibular defects in cases utilizing VSP compared to cases not utilizing VSP. Other surgical outcomes such as operative times, ischemia times, and complications are also examined.

Methods: A single institution retrospective study was conducted examining patients who underwent a segmental mandibulectomy and bony free flap reconstruction between January 2015 and July 2023. A group of 71 patients who underwent surgery utilizing VSP were compared to 44 patients who underwent surgery utilizing traditional methods. Mandibular defects were classified using a simplified Brown classification scheme by assessing computer-generated VSP guides and/or post-operative CT scans. The number of bony segments used in the mandibular reconstruction was our measure for complexity and was compared between both groups. Indication for surgery, free flap type, extent of neck dissection, ischemia time, total operative time, and post-operative complications were also analyzed.

Results: Patients were slightly older in the non-VSP group compared to the VSP group (65.9 vs 59.6 years, p = 0.014). Both the VSP and non-VSP groups had more males than females (64.8% vs 75.0%, p = 0.251). The most common indication for surgery within each group was cancer (74.7% VSP vs 97.8% non-VSP, p< 0.001). There was no significant difference in the size of mandibular defects between each group (p=0.143), however the VSP group had a significantly higher number of bony segments used for reconstruction (p < 0.001). Total operative time was similar between groups (706.6 vs 772.2 mins, p = 0.095), however ischemia time was significantly shorter in the VSP group (120.2 vs 147.0 mins, p = 0.021 ).

Conclusions: Our study suggests that VSP can allow for more complex reconstruction of mandibulectomy defects while reducing ischemia time compared to traditional reconstruction methods.

Presenting Author(s)

Ian L. Sunyecz, DO

Resident Physician
West Virginia University
Morgantown, WV, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Jeffson CH Chung, MD

Associate Professor Otolaryngology
West Virginia University
Morgantown, WV, United States

Disclosure information not submitted.

Co-Author(s)

RC

Ruifeng Cui, PhD

West Virginia University, West Virginia, United States

Disclosure information not submitted.
Adam S. Howard, MD

Assistant Professor
West Virginia University Department of Otolaryngology
Morgantown, WV, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Parker H. Tumlin, MD

Resident physician
West Virginia University
Morgantown, WV, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Bradford Dugan

Medical Student
West Virginia University School of Medicine
xxxx, United States

Disclosure information not submitted.