Virtual surgical planning technologies give surgeons a powerful new tool for their most challenging facial reconstruction cases, according to an article recently published in Plastic and Reconstructive Surgery®.
Dr Saad and colleagues report their experience with maxillofacial reconstruction in patients with severe facial defects. All patients had severe destruction and distortion of the facial structure, posing difficult surgical challenges with a high risk of complications.
Virtual surgical planning begins with a high-resolution 3D CT scan of the skull and facial defect, and of the donor site from which the surgeon will obtain bone and tissue flaps for use in reconstruction. The CT data are then used to ‘virtually restore’ the patient’s preinjury anatomy — including a computer simulation showing how multiple bone-containing flaps would be placed to restore the defect.
Dr Saad and coauthors used the virtual surgical planning system for reconstruction in 10 patients with severe facial defects.
All procedures went smoothly, with no surgical complications. The 3D model helped the surgeon understand the various components needed for the reconstruction, and how they would fit together. Using custom‑made cutting jigs and pre-bent plates allowed surgeons to work more efficiently, potentially reducing operating time.
Follow-up CT scans showed ‘excellent contour’ of the bone flaps used for reconstruction of the facial skeleton. All bone and tissue flaps were viable at 3 months’ follow-up. Where reconstruction of the mandible was performed, functional jaw motion was restored.
After initial experience with virtual surgical planning for simpler reconstructions, the researchers evaluated its use for the most complex maxillofacial reconstructions.