Objectives

Mandibular reconstruction after segmental mandibulectomy can be challenging without virtual surgical planning and osteotomy guides. The purpose of this study was to analyze anatomic parameters to facilitate the evaluation of ideal fibula wedge osteotomies to reconstruct the neomandibula in a simple and cost-effective manner without the need for preoperative virtual planning.

Materials and methods

Computed tomography scans were acquired from randomly selected patients, and all images were obtained from routine clinical diagnostics, e.g., tumor staging, or preoperatively before reconstruction. Data was used to calculate stereolithographic models of the mandible for length and angle measurements. Statistical analysis was performed (p < 0.05).

Results

CT scans of 100 patients were analyzed: 39 were female and 61 were male patients, mean age was 59.08a. The mandibular arch angle proved to be constant with 241.07 ± 2.39°. The outside B-segment length was 80.05 ± 5.16 mm; the anterior S-segment length was 27.69 ± 3.16 mm. The angle of the mandibular arch showed differences in means (p = 0.004) between age groups, but effect was proved low. No relevant statistical significances were detected.

Conclusions

The development of a mandible reconstruction template tool would benefit the majority of head and neck patients, which is due to a constant mandibular arch angle and symphysis segment length throughout the general patient population, allowing the mimicking of a harmonic mandibular arch with up to three fibula segments.

Clinical relevance

The developed mandible reconstruction template tool can facilitate the fibula wedge osteotomies necessary for reconstruction of an ideal neomandibula providing a novel approach which is simple and cost-effective.

中文翻译：

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通过对人体下颌骨进行数字分析，开发一种在腓骨截骨术中促进下颌骨缺损重建的模板工具。

目标

如果没有虚拟手术计划和切骨术指导，进行分段下颌骨切除后的下颌重建可能会很困难。这项研究的目的是分析解剖参数，以方便理想的腓骨楔形截骨术评估，以简单且经济高效的方式重建新下颌骨，而无需术前虚拟计划。

材料和方法

从随机选择的患者中获取计算机断层扫描，所有图像均从常规临床诊断（例如肿瘤分期）或术前重建中获得。数据用于计算下颌骨的立体光刻模型，以进行长度和角度测量。进行统计分析（p  <0.05）。

结果

分析了100例患者的CT扫描：女性39例，男性61例，平均年龄为59.08a。下颌弓角证明是恒定的，为241.07±2.39°。外侧B段长度为80.05±5.16 mm; 前S段长度为27.69±3.16 mm。下颌弓的角度显示 年龄组之间的均值差异（p = 0.004），但效果不佳。没有检测到相关的统计意义。

结论

下颌骨重建模板工具的开发将使大多数头部和颈部患者受益，这是由于在整个普通患者群体中，下颌弓角恒定且骨突节段长度长，从而可以模仿具有最多三个腓骨的谐调下颌弓段。

临床相关性

开发的下颌骨重建模板工具可以促进腓骨楔形截骨术，这对于重建理想的下颌骨是必需的，提供了一种简单且经济高效的新颖方法。