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Emre Vural, MD; James C. Yuen, MD

Arch Otolaryngol Head Neck Surg. 2007;133(6):603-607.

Objective  To obtain accurate occlusion in mandibular reconstruction when the tumor is exophytic, which makes prebending the plate impossible.

Design and Setting  Use of computed tomography–based resin models and external fixation devices is combined in a tertiary academic center. The exophytic part of the tumor on the model is burred off, and the reconstruction plate is bent on the model before surgery. Temporary external fixation is applied before resection, and a precontoured plate is applied following segmental resection before the release of external fixation.

Results  Six patients underwent mandibular reconstruction by using this technique, and all of the patients retained a class 1 occlusal relationship without need for additional intraoperative plate contouring.

Conclusion  Computer-generated resin models of the mandible combined with intraoperative temporary external fixation allow the maintenance of preoperative occlusal status.

Author Affiliations: Divisions of Otolaryngology–Head and Neck Surgery (Dr Vural) and Plastic and Reconstructive Surgery (Dr Yuen), Department of Surgery, Central Arkansas Veterans Healthcare System, John L. McClellan Memorial Veterans Hospital; and Department of Otolaryngology–Head and Neck Surgery (Dr Vural) and Division of Plastic and Reconstructive Surgery, Department of Surgery (Dr Yuen), University of Arkansas for Medical Sciences, Little Rock.