The Emerging Role of Three-dimensional Technologies in Orthoplastic Surgery

Three-dimensional (3D) planning and manufacturing technologies have become integral to head and neck reconstruction following tumor resection. These technologies facilitate the prototyping of patient-specific solutions in both digital and physical form. Three-dimensional tumor models and cutting guides help conceptualize and verify the surgical approach, as well as serve as a blueprint for reconstruction. Computer-aided renderings have been shown to add precision to bony contouring to achieve functional and aesthetic goals following tumor resection, such as in mastication, oral competence, speech, and symmetric facial aesthetics. Three-dimensional technologies have also been introduced in orthopedic oncology, making limb-salvage surgery the mainstay of treatment in cases where amputation was historically required. The advent of customized 3D cutting guides and plates allows surgeons to spare surrounding healthy tissue, markedly enhancing postoperative quality of life and significantly reducing associated morbidities. Borrowing from these applications of 3D planning and modeling, our institution has recently implemented these technologies for the reconstructive planning of soft tissue defects following sarcoma resection. Here we present a series of cases that demonstrate the workflow and clinical outcomes associated with the utilization of 3D planning techniques in orthoplastic surgery.