Carly Fassler, Michael C Topf, Alexis Miller, Whitney Jin, Juan M Colazo, Lauren Luther, Douglas Weikert, Kyle Mannion, Alexander J Langerman, Robert Sinard, Eben Rosenthal, Sarah Rohde
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引用次数: 0
Abstract
Objectives: The osteocutaneous radial forearm free flap (OCRFFF) is used for the reconstruction of bony head and neck defects. Being a weight-bearing bone, precise harvesting of the radius is required to maintain structural integrity, postoperative forearm function, and to prevent postoperative fracture. A radius cutting guide may allow head and neck surgeons to be more precise and confident in performing bony harvest, and may improve allocation of orthopedic specialist resources.
Methods: A custom radius cutting guide was developed in an iterative process with six head and neck surgeons and one hand surgeon. Following design approval, a prospective feasibility study was conducted. Patient-specific cutting guides were created using pre-operative upper-extremity computed tomography (CT) scans. The length and cross-sectional width of harvested radius bone were measured. The length of time using the guide was recorded. Providers were surveyed to assess their perception of cutting guide utility.
Results: A total of eight patients were enrolled, and the cutting guide was used successfully in seven patients. The mean length of the radius harvested was 77.1 ± 13.8 mm. The mean cross-sectional width of the radius planned for harvest was 11.7 ± 1.7 mm. The mean width of the bone harvested was 12.1 ± 1.2 mm, with a mean difference of + 0.81 mm. The mean total time using the guide was 12.94 min (range 10.0-20.1 min). Survey respondents (n = 7) agreed that the guide did not interfere with their ability to harvest radius bone (mean response 9.0 ± 1.3) and that they would utilize the guide in practice (9.4 ± 1.1).
Conclusions: Patient-specific cutting guides for OCRFFF harvest are feasible and may improve head and neck reconstructive surgeons' comfort with harvest.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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