Efficacy of computer-assisted surgery in mandibular bone reconstruction with fibula free flap

Abstract

Recently, computer-assisted surgery （CAS） has been applied in mandibular bone reconstruction. In this study, we compared the reproducibility, efficiency, and postoperative complications of CAS （TruMatch^Ⓡ） and non-CAS re­con­struc­tive surgery （freehand surgery） in order to verify the efficacy of CAS in fibular free flap reconstruction of the mandible.
Fourteen patients who underwent mandibular reconstruction with fibular free flap from April 2017 to May 2023 were evaluated. Ten patients underwent freehand surgery （9 males and 1 female; median age, 65 years; age range 52-76） and four patients underwent TruMatch^Ⓡ surgery （3 males and 1 female; median age, 59 years; age range 48-66 years）. Mean difference in pre- and postoperative mandibular angle was 16.2 degrees for freehand surgery and 2.6 degrees for TruMatch^Ⓡ, with TruMatch^Ⓡ being significantly smaller. TruMatch^Ⓡ had a shorter reconstruction time than freehand surgery compared with the same number of bone segments. Postoperative complications such as plate fracture were observed in 7 of 10 patients with freehand surgery. In contrast, no such complications were observed with TruMatch^Ⓡ.
These results suggest that mandibular bone reconstruction using CAS is useful in improving reproducibility of mandibular form, shortening the time required for reconstruction, and reducing postoperative complications related to the plate.