• Guangqi Yan, Xue Wang, Xuexin Tan, Xukai Wang, Mingliang Yang, and Li Lu.
• Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang Liaoning, 110002, P R China.
• Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Aug 1; 27 (8): 1006-9.

ObjectiveTo evaluate the directional significance of SurgiCase software in free fibula mandibular reconstruction.MethodsBetween September 2010 and March 2012, 10 patients with mandibular defect underwent free fibula mandibular reconstruction. There were 7 males and 3 females, with an age range of 19-43 years (mean, 27 years). The extent of lesions was 7 cm x 5 cm to 16 cm x 8 cm. In each case, three-dimensional spiral CT scan of the maxilla, mandible, and fibula was obtained before surgery. The CT data were imported into the SurgiCase software and the virtual surgery planning was performed. After that, the mandibular rapid prototyping was made according to customized design. The reconstruction surgery was then carried out using these preoperative data. During actual surgery, the extent of mandibular defect was from 6 cm x 3 cm to 16 cm x 5 cm; the length of fibula which was used to reconstruct mandible was 6-17 cm; and the area of flap was from 6 cm x 5 cm to 16 cm x 6 cm.ResultsPreoperative data could not be applied because the intraoperative size of tumor was larger than preoperative design in 1 case of mandibular ameloblastoma, and the fibula was shaped according to the actual osteotomy location; operations were performed successfully according to preoperative design in the other 9 patients. The operation time was 5-7 hours (mean, 6 hours). Primary healing of incision was obtained, without early complications. Ten patients were followed up 1 year. At last follow-up, 8 patients were satisfactory with the appearance and 2 patients complained with unsatisfied wide facial pattern. The panoramic radiograghs showed good bone healing. The range of mouth opening was 2.5-3.5 cm.ConclusionSurgiCase software can provide precise data for free fibula mandibular reconstruction during surgery. It can be applied widely in clinic.

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