Abstract

Jaw defects may occur due to various causes such as tumors, trauma, and diseases caused by infection such as osteomyelitis. Reconstruction of jaw defects has been improved by the free flaps and refined microvascular techniques. The deep circumflex iliac artery (DCIA) flap offers a large amount of bone for complex reconstructions of the mandible. However, several complications and adverse effects can occur, such as abnormal hip contour, hernia, severe bleeding tendency, gait disturbance, and hypoesthesia. To reduce these complications, the monocortical DCIA flap can be used, or iliac crest bone defects can be restored with titanium mesh. However, these methods have limitations when used to reduce hip contour reproduction and gait disturbance. In this study, we report a case of iliac bone reconstruction using a 3D-printed patient-specific implant to reduce donor site morbidity in the reconstruction of the DCIA flap in a patient with oral squamous carcinoma.

Highlights

  • Jaw defects may occur due to various causes such as tumors, trauma, and diseases caused by infection such as osteomyelitis

  • Hard and soft tissue free flaps used in reconstruction of the jaw include the radial forearm, scapula, fibula, and deep circumflex iliac artery (DCIA) flap [2]

  • The DCIA flap has been used with the fibula free flap for the reconstruction of jaw defects because it has the advantages of reproducing the natural shape of the arch, having sufficient width and height, and providing bicortical bone containing good-quality cancellous bone

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Summary

Introduction

Jaw defects may occur due to various causes such as tumors, trauma, and diseases caused by infection such as osteomyelitis. The DCIA flap has been used with the fibula free flap for the reconstruction of jaw defects because it has the advantages of reproducing the natural shape of the arch, having sufficient width and height, and providing bicortical bone containing good-quality cancellous bone It is useful for the restoration of partial defects in the mandible, such as segmental mandibulectomy and hemi-mandibulectomy [3]. Large bony defects in the ilium area during restoration of a wide bone defect cause weakening of the supporting tissue, which causes complications such as gait disturbance, iliac fracture, and hernia [3] To reduce this complication, the monocortical DCIA flap can be used, or titanium mesh can be applied to the iliac crest bone defect. The purpose of this study was to introduce a case involving reconstruction of the donor site using a patient-specific implant applied after reconstruction of a mandibular defect after segmental mandibulectomy due to primary squamous cell carcinoma in the mandible

Case Presentation
Computer-Assisted Surgical Planning
Surgical Technique
Discussion

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