Advantages of virtual planning in reconstructive surgery of bone defects in the maxillofacial region.

[OBJECTIVES] Our analysis focuses on the advantages of virtual surgical planning (VSP) compared to a conventional treatment method as well as on a wider range of parameters influencing the surgical procedure, postoperative care, morbidity and lastly, the survival rate of these patients.

[BACKGROUND] Patients with extensive bone defects of different etiologies of the upper or lower jaw who underwent complex reconstructive surgery with a free fibula flap (FFF).

[METHODS] We retrospectively analyzed data from a total of 34 patients (12 female and 22 male) whose defects were reconstructed with an osteomyocutaneus FFF. The data were collected over a period of 6 years from 2017 to 2023. We divided the patients into two groups, namely those who underwent conventional surgical treatment (5 patients) and those who underwent computer‑planned surgical treatment (29 patients).

[RESULTS] The duration of surgery showed a significant difference between the VSP group and the conventional group (t(32) = 3.316; p < 0.01), with the VSP group having a significantly shorter surgery time (M= 8:10; SD = 1:18) compared to the conventional group (M = 10:52; SD = 2:41). The independent t-test revealed significant differences between the VSP group (M = 45.967; SD 14.548) and conventional group (M = 17.61; SD = 24.996) for the dose of unfractionated heparin per kilogram administrated immediately after vascular micro anastomosis (t(32) = -3.609; p < 0.001).

[CONCLUSION] Among all the risk factors, administering a higher unfractionated dosage of heparin administered immediately after completing the anastomosis was identified as a significant predictor of postoperative complications. Using VSP in cases of advanced stage head and neck malignancy for salvage surgery is highly recommended. Shorter duration of these comprehensive surgeries in the VSP group leads to a significantly favorable outcome (Tab. 2, Fig. 2, Ref. 19). Text in PDF www.elis.sk Keywords: virtual planning, microvascular flap, maxillofacial, free fibula flap, reconstructive surgery.