Letters to the Editor-in-Chief
Published: 2024-02-29
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Comment to the article “Mandibular reconstruction using a new design for a patient-specific plate to support a fibular free flap and avoid the double-barrel technique” by Tarsitano et al., 2021

Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, SA6 6NL, United Kingdom. Corrisponding author - james.pallot@wales.nhs.uk
Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, SA6 6NL, United Kingdom
Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, SA6 6NL, United Kingdom
Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, SA6 6NL, United Kingdom
mandibular reconstruction fibular flap custom plate

Article

Dear Editor,

we read the article entitled ‘Mandibular reconstruction using a new design for a patient-specific plate to support a fibular free flap and avoid the double-barrel technique’ by Tarsitano et al, published in Acta Otorhinolaryngologica Italica, April 2021 1 with interest. We would like to show appreciation to the authors for their commendable work. The demonstration of technical steps used for fabrication of patient-specific implants for reconstruction of segmental mandibulectomy defects following resection of benign osseous mandibular tumours was comprehensive and impressive. CAD/CAM plates attained the desired goals of providing an aesthetic reconstruction of the inferior border of the mandible while positioning the fibula graft in a superior location adjacent to the native alveolar ridge to facilitate optimal insertion of implants for dental rehabilitation. Post-operative CT scans demonstrate excellent adherence to preoperative planning models and treatment outcomes in the series of cases described by the authors.

We would like to take this opportunity to highlight the technical note ‘Custom-made fibular “cradle” plate to optimise bony height, contour of the lower border, and length of the pedicle in reconstruction of the mandible’ by Goodson et al published in the British Journal of Oral and Maxillofacial Surgery, January 2017 2. Corresponding technical steps were used by these authors for reconstruction of a mandibulectomy defect following resection of an odontogenic myxoma. Similar software systems were used including DICOM and Mimicsâ for planning, provision of cutting guides, plate manufacture and commensurate clinical outcomes were attained.

While Goodson et al. did not undertake a software-based CT image comparison of their reconstructed case against the surgical plan like Tarsitano et al. did, we hope that their technical innovation regarding the inception of this plate design and its initial clinical use can be acknowledged.

Conflict of interest statement

The authors declare no conflict of interest.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author contributions

All authors listed were involved in writing and proof reading this letter to the Editor-in-Chief of Acta Otorhinolaryngologica Italica.

Ethical consideration

Not applicable.

References

  1. Tarsitano A, Battaglia S, Corinaldesi G. Mandibular reconstruction using a new design for a patient-specific plate to support a fibular free flap and avoid double-barrel technique. Acta Otorhinolaryngol Ital. 2021; 41:230-235. DOI
  2. Goodson A, Evans P, Goodrum H. Customised fibular cradle plate: a new concept in mandibular reconstruction; optimising bony height, lower border contour and pedicle length. Br J Oral Maxillofac Surg. 2017; 55:e123. DOI

Affiliations

James Pallot

Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, SA6 6NL, United Kingdom. Corrisponding author - james.pallot@wales.nhs.uk

Alex Goodson

Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, SA6 6NL, United Kingdom

Peter Evans

Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, SA6 6NL, United Kingdom

Madhav Kittur

Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, SA6 6NL, United Kingdom

Copyright

© Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale , 2024

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