Pioneering jaw reconstruction with 3D techniques and minimally invasive surgery

• August 14, 2014
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The description of the case has been published in the prestigious US Journal of Reconstructive Surgery, Plastic and Reconstructive Surgery GO.

Professionals from the Maxillofacial Surgery Service of Sabadell Hospital have recently performed innovative mandibular reconstruction surgery on a young patient affected by ameloblastoma (odontogenic tumor of embryonic remains), using the technique of 3D and minimally invasive surgery. This is the first time in the world that this combination of techniques has been published to extract such a large tumor (14 cm) and for subsequent mandibular reconstruction.

The techniques used allow the patient to recover more immediately, as he has to spend fewer hours in the operating room and reduces the possibility of complications due to infections and / or rejection of bone implants.

Maxillofacial surgery interventions with mandibular reconstructions for tumor involvement are usually performed with open surgery. Simultaneously, part of the patient's own fibula is removed and implanted (with microsurgical vascular anastomoses) in the jaw to replace the affected bone. Both the measurement of the part of the jaw to be removed and that of the portion of the fibula to be implanted are performed manually.

The technique allows the patient to recover more immediately and with less risk of complications and rejection

The novelties provided by the technique performed at Parc Taulí, according to the head of the Maxillofacial Surgery Service at Sabadell Hospital, Dr. Òscar Escuder are, on the one hand, the extraction of the tumor and subsequent placement of the fibula implant intraorally with the least possible extraoral approach, and on the other, the prior planning in 3D, using a computer, of the whole process of the intervention and, very particularly, the combination of both techniques.

This detailed planning is performed with the support of radiological images provided by the patient's CT scan of both the face and lower extremity. These 3D images are used (jointly by surgeons and engineers) to make the cutting templates of the areas to be operated, being calculated exactly the part of the fibula to be removed, with the cut and the shape that it must have to implant it in the jaw, so that the final reconstruction of this one is as precise and fast as possible.

Dr. Escuder points out that the operation carried out in Parc Taulí using the technique of 3D and minimally invasive surgery, without transparotid approaches to the condyle, has only been published worldwide in two patients with smaller mandibular tumors, and highlights the possibility of using the for other maxillary tumors.