THREE DIMENSIONAL VIRTUAL PLANNING, MODELLING AND PRINTING IN FIBULA FREE FLAP MANDIBULAR RECONSTRUCTIONS - INITIAL CASE SERIES IN A LIMITED RESOURCE ENVIRONMENT

The most contemporary approach when dealing with extensive head and neck defects post oncological resections is based on virtual computer planning, surgical resection/reconstruction simulation and three dimensional modeling and printing. It is of great benefit, particularly when the maxillo-mandibular area is involved, because of its complex three dimensional form and active functional load, both these features presenting a long-standing reconstructive challenge to the head and neck surgeons. Developing such complex surgical techniques is a very resource dependent undertaking and relies substantially on a strategic support from the given National Health Service system. An overview of the first 3 consecutive cases of entirely digitally planned and lab-to-theatre transferred mandibular resections and simultaneous microvascular fibula flap reconstructions performed in Sofia between August October 2017 is presented.