Evaluation of virtual surgical planning systems and customized devices in fibula free flap mandibular reconstruction

  • Jacques BlancEmail author
  • Carine Fuchsmann
  • Veronica Nistiriuc-Muntean
  • Pierre Jacquenot
  • Pierre Philouze
  • Philippe Ceruse
Head and Neck



The purpose of this study was to evaluate the accuracy of virtual planning using customized surgical devices (VP3D) in fibula free flap mandibular reconstruction.


Fourteen patients received VP3D and 16 patients underwent conventional surgery (CS). Virtual planning was compared to postoperative scans using cephalometric and three-dimensional (3D) measurements. Operative times of both VP3D and CS groups were compared.


Comparisons of cephalometric measurements revealed no significant difference between virtual planning and postoperative scans. 3D analysis demonstrated a high level of virtual planning accuracy. In the VP3D group, total operative time gain was 88 min (p < 0.001) and total ischemia time gain was 36 min (p = 0.04).


Virtual surgical planning using customized devices enables ‘tailored’ surgery that is accurate and reliable and results in operative and ischemia time gain.

Clinical trial



Mandibular defect Fibula flap Reconstruction Virtual planning Pre-bent plate 



None declared.

Compliance with ethical standards

Conflict of interest

The author(s) declare that they have no conflict of interests.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology-Head and Neck Surgery, Croix Rousse Hospital, Service d’ORL et chirurgie cervico-facialeHospices Civils de Lyon (Hospital Group of Lyon)LyonFrance
  2. 2.Department of Radiology, Lyon Sud HospitalHospices Civils de Lyon (Hospital Group of Lyon)Pierre-BéniteFrance
  3. 3.Department of Anesthesiology and Resuscitation, Croix Rousse HospitalHospices Civils de Lyon (Hospital Group of Lyon)LyonFrance
  4. 4.Claude Bernard UniversityLyon 1France

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