A-04 Use of 3D planning in primary microsurgical reconstruction of a facial defect

Modern complex oncological therapy of malignant orofacial tumors cannot even today be performed without extensive resection oncosurgical procedures. These have still the best effect on prognosis of the underlying disease. Extensive resection procedures are complicated in the area of the head and neck by complex anatomy and functional and aesthetic aspects. Primary reconstruction after these procedures is the best option for the patient to restore all functions of stomatognathic system. In spite of a great variability of the defects, there are five basic microsurgically transferred distant flaps used for the reconstructions in the head and neck area -⁠ vascularized bones from the hip, scapula, fibula and soft tissues from the forearm and anterior thigh. Limitation of primary microsurgical reconstruction is mainly the surgical time, since after a very demanding oncosurgical therapy follows a demanding reconstructive procedure. Our case report demonstrates the use of a modern CT navigated 3D planning and mainly transfer of this plan to the performance of a microsurgical reconstruction of the lower jaw using osteocutanous flap from fibula, which provides significantly more accuracy in the modeling of the flap but also shortened the time between detachment of the vessels and subsequent revascularization, as well as the whole duration of the surgery.