Intraoperative Real‐Time Image‐Guided Fibular Harvest and Mandibular Reconstruction: A Feasibility Study on Cadaveric Specimens Article Swipe
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· 2024
· Open Access
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· DOI: https://doi.org/10.1002/hed.27954
· OA: W4403158091
Background This study assesses the feasibility of real‐time surgical navigation to plan and guide sequential steps during mandible reconstruction on a series of cadaveric specimens. Methods An image‐guided surgical (IGS) system was designed including customized mandible and fibula fixation devices with navigation reference frames and an accompanied image‐guided software. The mandibular and fibular segmental osteotomies were performed using the IGS in all five cadaveric patients. Procedural time and cephalometric measurements were recorded. Results Five real‐time IGS mandibulectomy and fibular reconstruction were successfully performed. The mean Dice score and Hausdorff‐95 distance between the planned and actual mandible reconstructions was 0.8 ± 0.08 and 7.29 ± 4.81 mm, respectively. Intercoronoid width, interangle width, and mandible projection differences were 1.15 ± 1.17 mm, 0.9 ± 0.56 mm, and 1.47 ± 1.62 mm, respectively. Conclusion This study presents the first demonstration of a comprehensive image‐guided workflow for mandibulectomy and fibular flap reconstruction on cadaveric specimens and resulted in adequate cephalometric accuracy.
