Abstract
rehabilitation. Fibular free flaps were utilized to immediately reconstruct themaxilla andmandible in six patients, facilitating orthognathic jaw position, favorable facial projection, separation of the nose and mouth, and oral competence. The remaining patients were treated without microvascular free tissue transfer, but the virtual planning, pre-bent reconstruction plates, and intraoperative imaging significantly aided accurate reconstruction. Intraoperative CT scans facilitated recognition of minor inaccuracies in orbital plate placement in two patients, the position of which was corrected prior to leaving the operating room. Conclusion: Computer-aided presurgical planning, custom cutting guides and guide stents, and intraoperative imaging have the potential to favorably affect the functional and aesthetic outcomes of patientswith severe facial injuries resulting from gunshot wounds.
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