Application of Open-Source 3D Planning Software in Virtual Reconstruction of Complex Maxillofacial Defects

ABSTRACT Objective: To present our in-house 3D planning protocol utilizing open-source computer-aided design software and discuss specific applications in reconstruction of various craniomaxillofacial defects, demonstrating a free, accessible, efficient, accurate, and easily learnable alternative to expensive counterparts. Methods: Design: Case Series Setting: Tertiary Private Training Hospital Participants: Ten (10) patients who underwent CAD assisted reconstructive surgeries from February 2017 – May 2018. Results: A total of 10 patients were included; 7 mandibular reconstructions were surgically reconstructed using our 3D planning protocol and achieved symmetric mandibular contour, with good functional occlusion after surgery; 1 cranioplasty and 1 orbital trauma case also achieved good symmetry and adequate correction of enophthalmos respectively. However, inadequate soft tissue correction was seen in 1 case of maxillary reconstruction despite achieving symmetric bony contour. Conclusion: Our 3D planning protocol using open-source CAD applications is a viable alternative to expensive professional counterparts. Additional prospective studies may better demonstrate benefits in terms of accuracy and decreasing intraoperative time in craniomaxillofacial and head and neck reconstruction.