Virtual surgical planning for maxillary reconstruction with the scapular free flap: An evaluation of a simple cutting guide design

Abstract

BACKGROUND: The study's objective is to assess the feasibility and utility of VSP for maxillary reconstruction with the scapular free flap. METHODS: An open-source VSP platform was used to create the reconstruction models and simple guides. Clinical, operative, and postoperative data were collected. RESULTS: Ten patients in the VSP cohort and 18 in the non-VSP control cohort were included in the study. There was a significant reduction in operative time (256.0 ± 69.4 vs. 448.1 ± 108.2 min, p < 0.01), tracheotomy rate (20% vs. 72%, p < 0.01), increased two-team utilization rate (80% vs. 0%, p < 0.01) and better reconstructive accuracy (7.5 ± 3.4 vs. 11.7 ± 7.6 mm, p = 0.048) for the VSP cohort. CONCLUSIONS: Maxillary reconstruction planned with an in-house open-source VSP platform and accompanied simple guides can facilitate a two-team approach, reduce operative time, and improve structural accuracy. This open-source technology has great potential to be readily applied in other institutions to improve efficiency and outcomes.