For patients who undergo a jaw reconstruction after head and neck cancer surgery, computer design and manufacturing techniques (CAD/CAM) can improve some key clinical results, reports a study in Plastic and reconstructive surgeryThe Official Medical Journal of the American Society of Plastic Surgeons (ASPS).
“Our Experience suggests that cad/cam techniques sacrifice severe benefits in patients undergoing free fibula reconstruction of the loower jaw, including a reduced risk of long-term complications reowering hardware removal, members member’s member, or says me. Member’s Member, Member’s Member, Member’s Member, Member’s Member, Member’s Member, Member’s Member, Members Member, Member’s Members Member, Member’s Member’s Member, Member’s Member Member, Member’s Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Member Meam.
CAD/CAM has ‘revolutionized’ the reconstruction of the jaw: does the patient’s results improve?
Around the last decade “[P]Reoperative virtual surgical planning through CAD/CAM has revolutionized the way we approach the reconstruction of the head and neck “, according to the authors. Using CAD/CAM technology, surgeons can design and create” specific cutting guides three -dimensionally specific to the patient “, as well as preformed hardware for their use in reconstruction.
CAD/CAM has been applied successful to the reconstruction of “Free Dongaus flap” after head and neck cancer surgery, using grafts of bones and tissues from the bottom of the leg to rebuild the jaw. “However, given the relatively recent introduction [of CAD/CAM]The studies that carry out a head comparison with the conventional technique are limited, “write Solari and Coouthors.
His new study directly compares the short -term results of the reconstruction of the conventional free fin and CAM assisted by fibula.
The study included 215 patients undergoing the reconstruction of fibula free of the lower jaw (jaw) between 2012 and 2021, mainly after cancer surgery. Of these, 136 patients had an assisted reconstruction by CAD/CAM and 79 underwent conventional reconstruction.
Better efficiency and precision with CAD/CAM leads to clinical benefits
Patients undergoing a reconstruction assisted by CAD/CAM spent less time in the operating room (OR), approximately one hour less than the conventional group. There were no significant differences in the hospital days.
Most of the short -term complications were similar among the groups, including the return to the OR, the greater bleeding, the complications related to the blood clot and the total and complete loss rates of the free fibulaeum flap were also similar. However, the CAD/CAM group was less likely to have dehiscence (reopening) of the incision site: 7.4% versus 16.5%.
The analysis of the longer term results (2 to 2.5 years) focused on 195 patients without important complications in the first 30 days. Although most of the long -term complications were similar among the groups, the patients undergoing a reconstruction assisted by CAD/CAM were less small to need greater surgery to eliminate reconstruction hardware. After adjusting possible risk factors, patients in the CAD/CAM group were 60% less likely to undergo hardware elimination.
The reduction in the time of the operating room reflects “the lack of hardware manipulations that require a lot of time and bone adjustments” with the conventional reconstruction of fins of free fins, the researchers write. Previous studies have reported greater precision and solid bone fusion with CAD/CAM; These improvements can lead to a reduction in long -term complications that require hardware elimination.
The study adds new evidence that the integration of CAD/CAM techniques provides significant clinical benefits for patients undergoing jaw. Solari and his colleagues conclude: “Given the additional cost with the use of CAD/CAM, future studies that focus on the profitability of this approach with respect to long -term results and hardware maintenance will be important to justify the clinical importance of our.”
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