Computer-assisted zygoma reconstruction with vascularized iliac crest bone graft

Abstract

Background: The reconstruction of zygoma is a challenge with regard to aesthetic and reconstructive demands.

Methods: Pre-operative CT data were imported into specific surgical planning software. The mirror-imaging technique was used. A surgical guide transferred the virtual surgery plan to the operation site, whereby it fitted uniquely to the iliac donor site. A postoperative CT scan was obtained for comparing the actual postoperative graft position and shape with the pre-operative virtual simulation.

Results: A mean difference of 0.71 mm (SD ± 1.42) for the shape analysis and 3.53 mm (SD ± 3.14) for the graft position was determined. The calculation of the closest point distance showed a surface deviation of < 2 mm for the shape analysis with 83.6% of values and for the graft position with 35.7% of values.

Conclusion: Virtual surgical planning is a suitable method for zygoma reconstruction with vascularized iliac crest bone graft, with good accuracy for restoring the three-dimensional anatomy.

Keywords: computer-assisted surgery; surgical guide; vascularized iliac crest bone graft; virtual planning; zygomatic reconstruction.