Craniomaxillofacial Free Flap Reconstruction Using Virtual Surgical Planning

  • James Leighton Mayo
  • Hugo St. Hilaire


Through the evolution of microsurgery, imaging techniques, and CAD-CAM technology, virtual surgical planning (VSP) has become a routine tool for reconstructive microsurgeons. Its application can aid in improved operative efficiency as well as more accurate and consistent results. To realize the full potential of VSP, well-structured and detailed planning must occur. Data is gathered via thinly sliced CT scans of both the donor site and the site of reconstruction. A team-oriented planning session then ensues, mapping out the area of extirpation and outlining the goals of reconstruction. Finally, the surgery is executed in a consistently efficient manner using prefabricated surgical models, cutting guides, and, at times, pre-bent plates. The result is a more efficient surgery with predictably more accurate results. This chapter will fully outline the key components to integrating VSP into head and neck reconstruction.

The applications for VSP within head and neck reconstruction are numerous. A strong working knowledge of the bone flaps available for reconstruction is advantageous when faced with varied reconstructive challenges. The fibula, iliac, scapular, and radial bone flaps are outlined in this chapter with a description of the pertinent anatomy, pearls for flap harvest, and application to specific reconstructive areas. Finally, key concepts for site-specific reconstruction are presented including mandible, maxilla, orbito-maxilla, and fronto-orbital units. With a solid understanding of VSP planning and execution, various bone flaps for reconstruction, and site-specific key concepts, the head and neck reconstructive surgeon can provide predictably favorable results in an efficient manner.


Mandibular reconstruction Maxillary reconstruction Fronto-orbital reconstruction Virtual surgical planning CAD-CAM technology Patient-specific plate 


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Aesthetic and Reconstructive Surgery InstituteOrlando Health-University of Florida Cancer Center of OrlandoOrlandoUSA
  2. 2.Division of Plastic & Reconstructive Surgery, Department of SurgeryLouisiana State UniversityNew OrleansUSA

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