Reliabilities of three methods used to evaluate computer-assisted mandibular reconstructions using free fibula flaps
Tingwei Bao,
Di Yu,
Wenyuan Zhu,
Jianfeng He,
Jiaqi Zheng,
Huiming Wang
Affiliations
Tingwei Bao
Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, 79# Qingchun Road, Hangzhou, Zhejiang, China; Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China, 268# Kaixuan Road, Hangzhou, Zhejiang, China
Di Yu
General Department, Hangzhou Dental Hospital, Hangzhou, China, 1# Pinghai Road, Hangzhou, Zhejiang, China
Wenyuan Zhu
Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, 79# Qingchun Road, Hangzhou, Zhejiang, China; Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China, 268# Kaixuan Road, Hangzhou, Zhejiang, China
Jianfeng He
Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, 79# Qingchun Road, Hangzhou, Zhejiang, China; Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China, 268# Kaixuan Road, Hangzhou, Zhejiang, China
Jiaqi Zheng
Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, 79# Qingchun Road, Hangzhou, Zhejiang, China
Huiming Wang
Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, 79# Qingchun Road, Hangzhou, Zhejiang, China; Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China, 268# Kaixuan Road, Hangzhou, Zhejiang, China; Corresponding author. Department of Oral and Maxillofacial Surgery The First Affiliated Hospital, School of Medicine, Zhejiang University 79# Qingchun Road, Hangzhou, Zhejiang, China.
Objective: This study compared the reliabilities of three different methods used to calculate surgical deviations after mandibular reconstructions using free fibular flaps. Study design: This retrospective study involved 35 patients who underwent computer-assisted mandibular reconstructions using free fibula flaps. The deviations between the virtual surgical plans and the postoperative results were independently analyzed by two researchers using three distinct methods. In Method A, the fibular axis, the center of gravity, and the osteotomy plane served as landmarks when measuring surgical deviations. In Methods B and C, manually designated points were used to measure errors in the fibular length and intersegmental angle. The primary outcome variables were the intraclass correlation coefficients (ICCs) that revealed the inter-rater agreements for all three methods. Results: The use of Method A was associated with good agreement in terms of the fibular length deviation (ICC = 0.765) and intersegmental angle (ICC = 0.897); both were higher than those afforded by Methods B (ICC = 0.158 and 0.108) and C (ICC = 0.406 and 0.463). The measurements of the fibular transfer osteotomy deviation (ICC = 0.888), linear deviation (0.926), and angular deviation (0.958) were very reliable. Conclusions: Method A afforded the highest reliability in clinical practice when evaluating surgical deviations after mandibular reconstruction using fibular flaps.
