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Meta-Analysis
. 2019 Dec;144(6):1417-1428.
doi: 10.1097/PRS.0000000000006261.

Computer-Assisted versus Conventional Freehand Mandibular Reconstruction with Fibula Free Flap: A Systematic Review and Meta-Analysis

Warit Powcharoen  1 , Wei-Fa Yang  1 , Kar Yan Li  1 , Wangyong Zhu  1 , Yu-Xiong Su  2   1
Affiliations
Meta-Analysis

Computer-Assisted versus Conventional Freehand Mandibular Reconstruction with Fibula Free Flap: A Systematic Review and Meta-Analysis

Warit Powcharoen et al. Plast Reconstr Surg. 2019 Dec.

Abstract

Background: Computer-assisted mandibular reconstruction facilitates preoperative surgery simulation and transfers the virtual plan to a real operation. This systematic review and meta-analysis aimed to compare the accuracy, efficiency, postoperative complications, and economic viability between computer-assisted mandibular reconstruction and conventional freehand mandibular reconstruction.

Methods: The PubMed, Embase, Cochrane Library, and Google Scholar databases were searched up to November of 2018. The accuracy, efficiency, postoperative complications, and economic viability of computer-assisted mandibular reconstruction compared to conventional freehand mandibular reconstruction were systematically reviewed. Continuous and dichotomous data were pooled in mean difference (or standardized mean difference if necessary) and odds ratio, subsequently, with 95 percent confidence interval.

Results: A total of 12 studies were included in the systematic review, and data extracted from 11 of them were combined in meta-analysis. The accuracy of computer-assisted mandibular reconstruction was better than or equal to that of conventional freehand mandibular reconstruction according to qualitative analysis, although the quantitative comparison from meta-analysis was excluded because of the diversity of measurements. As for efficiency, computer-assisted mandibular reconstruction, when compared to conventional freehand mandibular reconstruction, revealed a shorter ischemic time, reconstructive time, total operative time, and length of stay. There was no difference in postoperative complication rate.

Conclusions: Computer-assisted mandibular reconstruction showed increased efficiency considering the reduced ischemic time, total operative time, reconstructive time, and length of stay. However, the accuracy, reconstruction outcomes, and perioperative cost should be further elucidated because of diverse measurements and the lack of included studies.

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References

    1. Weitz J, Bauer FJ, Hapfelmeier A, Rohleder NH, Wolff KD, Kesting MR. Accuracy of mandibular reconstruction by three-dimensional guided vascularised fibular free flap after segmental mandibulectomy. Br J Oral Maxillofac Surg. 2016;54:506–510.
    1. Pellini R, Mercante G, Spriano G. Step-by-step mandibular reconstruction with free fibula flap modelling. Acta Otorhinolaryngol Ital. 2012;32:405–409.
    1. Han HH, Kim HY, Lee JY. The pros and cons of computer-aided surgery for segmental mandibular reconstruction after oncological surgery. Arch Craniofac Surg. 2017;18:149–154.
    1. Yang WF, Choi WS, Leung YY, et al. Three-dimensional printing of patient-specific surgical plates in head and neck reconstruction: A prospective pilot study. Oral Oncol. 2018;78:31–36.
    1. Metzler P, Geiger EJ, Alcon A, Ma X, Steinbacher DM. Three-dimensional virtual surgery accuracy for free fibula mandibular reconstruction: Planned versus actual results. J Oral Maxillofac Surg. 2014;72:2601–2612.

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