Abstract
Keywords
Mandible reconstruction after benign tumor excision usually requires a free vascularized bone graft. However, good cosmetic and functional results are not easy to achieve. The three-dimensional (3D) bio-model is a technique based on computer tomography (CT). The use of this technique in reconstructive surgery has increased in recent years. The patient suffered from an odontogenic keratocyst (OKC) located between the ramus and angle of the left mandible (Panel A). The 3D stereolithography method was used to design a pre-operative bio-model. One model was designed to define the excision margins of the lesion site. The contralateral site served as a mirror to create the template and a second model was printed to preform the reconstructive plate to the mandible (Panel B upper). After tumor excision, a single stage reconstruction was performed with a left free fibula osteoseptocutaneous flap (Panel B lower). At 18 months follow-up, the bone had good union, and the patient showed a good aesthetic result, proper occlusion, and normal masticatory function (Panel C and D). We propose that the 3D bio-model can assist surgeons to evaluate the size of the defect, design osteotomies tailored to the defect, and shaping of the titanium plate to fit the mandible pre-operatively, which shortens the operative time.
Article info
Editorial Information
Publication History
Received date: May 08, 2017
Accepted date: May 08, 2017
Published date: May 09, 2017
Funding
None
Conflict of Interest
None
Informed Consent
Patient consent was obtained for the publication of this case and any accompanying images.
Copyright
© 2017 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY).
Author Info
Cheng-I Yen, MD
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan
Pang-Yun Chou, MD
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan
Angela Ting-Wei Hsu, MS
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan
- Faculty of Medicine, Mackay Medical College, New Taipei City, Taiwan
Mark Shafarenko, BSc
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Georgios Kolios, MD, MBA
Department of Plastic and Reconstructive Surgery, Agaplesion Diakonie Klinikum, Hamburg, Germany
Chieh-Tsai Wu, MD
Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan
Soo-Ha Kwon, MD
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan
Chien-Tzung Chen, MD
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Keelung Branch and Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan
Tommy Nai-Jen Chang, MD
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan
Correspondence: Tommy Nai-Jen Chang, MD
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan
Email: Tommynjchang@yahoo.com.tw