Oral & Maxillofacial Surgery

The Client
Oral and Maxillofacial Surgeon

The Case Report
A 69 year old male patient presented with a T4 advanced intra-alveolar carcinoma of the left hemimandible, and in poor general health, including COAD, ischaemic heart disease.

The patient was not a candidate for a resection and reconstruction by microvascular techniques due to poor peripheral vasculature and a long general anaesthetic posed significant morbidity.

The Bio-model Development
As the tumour had eroded the bone and invaded soft tissue a plate could not be fashioned directly on to the bone at the time of surgery as the resection margins would be breeched. The original three dimensional structure of the resected mandible would also be difficult to reproduce post resection without a bio-model. It was decided to synthesise a patient specific bio-model, and from this plan the resection and bend a mandibular locking screw plate accurately against the bio-model.

A left redical neck dissection was performed with resection of the hemimandible in continuity. The plate was then positioned, fitting the condylar neck and symphyseal area accurately.

The application of the plate post resection took 25 minutes to carry out, saving much time in plate bending and achieving an excellent anatomical reproduction of the mandible in 3D.

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