Desenvolvimento de guia de corte cirúrgico customizado para mandibulotomia em cirurgia de cabeça e pescoço através da manufatura aditiva

Abstract

Purpose: The development of additive manufacturing, the use of biomodels, computer-aided design/computer-aided modelling, use of surgical cutting guides in Head and neck surgery made some specific surgical acts reach new paradigms. The aim of this work was to manufacture custom surgical cutting guides to mandible osteotomies through additive manufacturing. Materials and Methods: One selected patient with left mandible ramus tumor underwent virtual surgery with osteotomies using the custom surgical cutting guide (CSCG). The biomodel and the surgical cutting guide were designed using the software Rhinoceros v.5. The pre- bending of the plate and pre-fixation of screws were done days before the surgery, with timing measurement in each stage. The surgery was performed with new time measures and verifying the execution of the CSCG. Results: There was gain in operative time with the pre-bending stage and using the surgical cutting guide, because previously was known the plate position with the use of biomodel and the pre-choosen fixation of screws. At the surgical act was seen some difficulties to assembly the custom surgical cutting guide and the osteotomies was performed with an alternative way of cutting that was not previewed in the virtual surgery stage. Even so, the surgery in vivo was done at shorter operative time. Conclusions: With the use of GCCC, there was a decrease in surgical time and allowed greater predictability in the procedure. Due to the difficulties find with the use of the CSCG purposed, a new virtual design was done, considering the correction of the aspects finded at the surgery for future research and applications.