Changes In Condylar Position After Fibular Free-Flap Mandibular Reconstruction

To compare changes in condylar position after mandibular reconstruction with fibular free-flap and the differences of computer-assisted technique and traditional method on CT images. 34 patients who underwent mandibular reconstruction with fibular free-flap were selected according to the inclusion and exclusion criteria. In the 3D group, virtual surgical planning (VSP) with osteotomy cutting plate and placement guiding plate were used, while the traditional group underwent freehand reconstruction. CT data of 68 temporomandibular joints TMJs were recorded before and immediately after surgery. The condylar position was evaluated by measuring the anterior space (AS), posterior space (PS), and superior space (SS) and calculated the ln(PS/AS) according to the method of Pullinger and Hollender. The condyle on the ipsilateral side of the 3D group moved slightly backward and the traditional group moved largely anteroinferior. No obvious changes were noted on the contralateral side. In contrast with the traditional group, the 3D group presented less condylar displacement on ipsilateral side postoperatively. Virtual surgical planning improved accuracy of FFF mandibular reconstruction and made the condylar position more stable.