Navigation-Guided Harvesting of Autologous Iliac Crest Graft for Mandibular Reconstruction

Osseous reconstructions with free tissue transfer techniques in the facial region are well established and provide satisfactory results. Also, the introduction of new planning and transfer tools has simplified the surgical process for mandibular reconstruction. The reconstruction of the mandible remains very challenging: functional aspects like speech, swallowing, and chewing—with the help of dentures—have to be taken into account in the same way as esthetic aspects of the patient’s facial appearance. Although many authors report very good results using the free fibula flaps, this technology still has some disadvantages. In dentate patients especially with hemimandibulectomy, the gracile fibula bone causes an asymmetric facial appearance and inappropriate load situations between the strong healthy hemimandible and the reconstructed part. This may subsequently lead to complications. The iliac crest bone was reported to be the first choice for these patients. 1-3 For reconstructive surgical interventions with free-fibula flaps, several methods for virtual planning and transfer of the planning to the patient