For patients undergoing jaw reconstruction after head and neck cancer surgery, computer design and manufacturing techniques (CAD/CAM) can improve some key clinical results, reports a study on the Mayo of May of Plastic and reconstructive surgery®, the official medical magazine of the American Society of Plastic Surgeons (ASP). The magazine is published in the Lippincott portfolio by Wolters Kluwer.
“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 requires hardware,” comments member member member me. Member Member Member Member Member Membling Member Member Member Membling Member Member Member Member Member Member Membling Member Member Memorment Memorial Member.
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 authors. Using CAD/CAM technology, surgeons can design and create” three -dimensionally printed specificity reconstruction.
CAD/CAM has been applied successfully to the reconstruction of “Fin Free of Pier” after the surgery for head and neck cancer, using bone and tissue grafts 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 comparison of head heads with the conventional technique are limited, “writes Dr. Solari and co -authors. His new study directly compares the short -term results of the reconstruction of the flap of pejéé of conventional fibula and CAM/CAM.
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 between the groups, including the return to the OR, the main complications and the rates of blood clots and the total rates and the complete loss of the free felling 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 free of fingers, 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. Dr. 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.”
Plastic and reconstructive surgery® is published by Wolters Kluwer.
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Article: “Computer design and manufacturing in the reconstruction of free fibula
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