Realizing in-house algorithm-driven free fibula flap set up within 24 hours
Please always quote using this URN: urn:nbn:de:bvb:20-opus-353945
- Objective: This study aims to critically evaluate the effectiveness and accuracy of a time safing and cost-efficient open-source algorithm for in-house planning of mandibular reconstructions using the free osteocutaneous fibula graft. The evaluation focuses on quantifying anatomical accuracy and assessing the impact on ischemia time. Methods: A pilot study was conducted, including patients who underwent in-house planned computer-aided design and manufacturing (CAD/CAM) of free fibula flaps between 2021 and 2023. Out of all patient cases, weObjective: This study aims to critically evaluate the effectiveness and accuracy of a time safing and cost-efficient open-source algorithm for in-house planning of mandibular reconstructions using the free osteocutaneous fibula graft. The evaluation focuses on quantifying anatomical accuracy and assessing the impact on ischemia time. Methods: A pilot study was conducted, including patients who underwent in-house planned computer-aided design and manufacturing (CAD/CAM) of free fibula flaps between 2021 and 2023. Out of all patient cases, we included all with postoperative 3D imaging in the study. The study utilized open-source software tools for the planning step, and three-dimensional (3D) printing techniques. The Hausdorff distance and Dice coefficient metrics were used to evaluate the accuracy of the planning procedure. Results: The study assessed eight patients (five males and three females, mean age 61.75 ± 3.69 years) with different diagnoses such as osteoradionecrosis and oral squamous cell carcinoma. The average ischemia time was 68.38 ± 27.95 min. For the evaluation of preoperative planning vs. the postoperative outcome, the mean Hausdorff Distance was 1.22 ± 0.40. The Dice Coefficients yielded a mean of 0.77 ± 0.07, suggesting a satisfactory concordance between the planned and postoperative states. Dice Coefficient and Hausdorff Distance revealed significant correlations with ischemia time (Spearman's rho = −0.810, p = 0.015 and Spearman's rho = 0.762, p = 0.028, respectively). Linear regression models adjusting for disease type further substantiated these findings. Conclusions: The in-house planning algorithm not only achieved high anatomical accuracy, as reflected by the Dice Coefficients and Hausdorff Distance metrics, but this accuracy also exhibited a significant correlation with reduced ischemia time. This underlines the critical role of meticulous planning in surgical outcomes. Additionally, the algorithm's open-source nature renders it cost-efficient, easy to learn, and broadly applicable, offering promising avenues for enhancing both healthcare affordability and accessibility.…
Subtitle (English): | a pilot study evaluating accuracy with open-source tools |
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Author: | Andreas Vollmer, Babak Saravi, Niko Breitenbuecher, Urs Mueller-Richter, Anton Straub, Luka Šimić, Alexander Kübler, Michael Vollmer, Sebastian Gubik, Julian Volland, Stefan Hartmann, Roman C. Brands |
URN: | urn:nbn:de:bvb:20-opus-353945 |
Document Type: | Journal article |
Faculties: | Medizinische Fakultät / Klinik und Poliklinik für Mund-, Kiefer- und Plastische Gesichtschirurgie |
Language: | English |
Parent Title (English): | Frontiers in Surgery |
Year of Completion: | 2023 |
Volume: | 10 |
Article Number: | 1321217 |
Source: | Frontiers in Surgery (2023) 10:1321217. https://doi.org/10.3389/fsurg.2023.1321217 |
DOI: | https://doi.org/10.3389/fsurg.2023.1321217 |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 617 Chirurgie und verwandte medizinische Fachrichtungen |
Tag: | computer-aided; design; fibula; graft; ischemia; manufacturing (CAD/CAM); osteocutaneous mandibular; planning; preoperative; reconstruction |
Release Date: | 2024/05/08 |
Date of first Publication: | 2023/12/15 |
Note: | Funding The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article. |
Licence (German): | CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International |