The Shape of Things to Come: In-Hospital Three-Dimensional Printing for Mandibular Reconstruction Using Fibula Free Flap

Objectives/Hypothesis The aim of this study was to explore whether the production of in-hospital, low-cost surgical cutting guides would be possible and to assess different cutting guide shapes to facilitate the surgery and the application with instruments. Study Design Cohort study. Methods Using free computer-aided design software, surgical cutting guides for the mandible and fibula were designed and used to perform virtual segmental osteotomies and fibula transplants in seven patients. Results Fourteen virtual osteotomies were performed using the free software and the proposed workflow. Thirteen guides were then printed to transfer the virtual planning information to the operating room. Conclusions Virtual planning and the three-dimensional (3D) printing of guides for mandibular reconstruction is reliable with the aid of an in-hospital 3D laboratory. We also demonstrated that different guides with different shapes could be produced with benefits during surgery. Level of Evidence 4Laryngoscope, 2020