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Novel approach to maxillary reconstruction using osteocutaneous free tissue transfer with a customized stent
Author(s) -
Varma Vivek R.,
Yiu Yin,
Putten Meade,
Kessling Tiffany L.,
Ozer Enver,
Agrawal Amit,
Teknos Theodoros,
Kang Stephen Y.,
Old Matthew O.
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24855
Subject(s) - osteoradionecrosis , medicine , stent , surgical planning , free flap , rehabilitation , orthodontics , surgery , dentistry , radiation therapy , physical therapy
Abstract Background Computer‐guided 3D virtual planning and customized templates are novel and effective methods aiding maxillary reconstruction, particularly during osteocutaneous free tissue transfer of complex defects. However, virtual planning and modelling is often expensive. Methods We present a new method to reconstruct complex defects with a surgical stent designed from presurgical casts. We present 2 patients who underwent this technique. Reconstruction in both cases was aided by a surgical stent fashioned preoperatively to approximate the anatomic dimensions of the defect, guiding the shape and orientation of the flap during inset to aid in dental rehabilitation. Results Surgery was performed without evidence of malocclusion, oronasal separation, or osteoradionecrosis with both patients undergoing successful rehabilitation and showing good postoperative oral intake. Conclusion Utilization of our novel surgical stent allowed reconstruction of complex maxillectomy defects and facilitated the design of a reconstructive flap without the need of pre‐bent plates, cutting guides, or associated expenses.