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• W2555296711 abstract "<h3>Importance</h3> Segmental mandibulectomy for tumors that distort the buccal surface of the mandible present a reconstructive challenge. <h3>Objective</h3> To determine whether mandible alignment after navigation-guided mandible reconstruction is better than alignment after non–template-assisted freehand reconstruction and as good as template-assisted reconstruction in a cadaveric trial. <h3>Design, Setting, and Participants</h3> A cadaveric trial using 10 specimens was conducted at a tertiary academic center. Fiducials were created on the ramus to compare alignment with each intervention. Segmental mandibulectomy was performed on each cadaver. Each cadaver underwent navigation-guided reconstruction, template-assisted reconstruction using a manually shaped plate, and non–template-assisted freehand reconstruction with plate contouring performed after mandibulectomy. The study was conducted from October 1, 2015, to January 1, 2016; data analysis was performed from February 1, 2016, to March 1, 2016. <h3>Interventions</h3> Segmental mandibulectomy, navigation-guided reconstruction, template-assisted reconstruction using a manually shaped plate, and non–template-assisted freehand reconstruction. <h3>Main Outcomes and Measures</h3> Ramus fiducial coordinates were recorded at baseline and after each intervention. Mandible dimensions were measured using cephalometric landmarks. Postintervention and baseline differences in ramus and mandible position were calculated. <h3>Results</h3> Ramus alignment was not significantly different between navigation-guided and template-assisted reconstruction, differing by 0.54 mm (98.3% CI, −0.38 to 1.47 mm). Non–template-assisted freehand reconstruction was associated with a 3.14-mm difference in alignment compared with template-assisted reconstruction (98.3% CI, 1.09 to 5.19 mm). Navigation-guided alignment resulted in a 3.69-mm improvement in alignment compared with non–template-assisted freehand reconstruction (98.3% CI, 1.79 to 5.58 mm). There was some improvement in the gonion-gonion and lingula mandibulae–lingula mandibulae (Lm-Lm) alignment for navigation-assisted compared with non–template-assisted freehand reconstruction by 1.97 mm (98.3% CI, −0.65 to 4.58 mm) and 1.39 mm (98.3% CI, −0.17 to 2.95 mm), respectively. There was marginal evidence of better Lm-Lm alignment for navigation-guided than template-assisted reconstruction (0.44 mm; 98.3% CI, −0.06 to 0.95 mm). <h3>Conclusions and Relevance</h3> Mandible alignment following navigation-guided reconstruction is similar to template-assisted reconstruction. Navigation-guided alignment is likely better than non–template-assisted freehand reconstruction, and navigation guidance offers a reliable technique for real-time adjustment when reconstructing complex surgical defects, such as tumors effacing the buccal cortex of the mandible." @default.
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• W2555296711 date "2017-03-01" @default.
• W2555296711 modified "2023-09-26" @default.
• W2555296711 title "Navigation Guidance During Free Flap Mandibular Reconstruction" @default.
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• W2555296711 doi "https://doi.org/10.1001/jamaoto.2016.3204" @default.
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