The Shape of Things to Come: In-Hospital Three-Dimensional Printing for Mandibular Reconstruction Using Fibula Free Flap

Objectives/Hypothesis: The aim of this study was to explore whether the production of in-hospital, low-cost surgical cutting guides would be possible and to assess different cutting guide shapes to facilitate the surgery and the application with instruments. Study Design: Cohort study. Methods: Using free computer-aided design software, surgical cutting guides for the mandible and fibula were designed and used to perform virtual segmental osteotomies and fibula transplants in seven patients. Results: Fourteen virtual osteotomies were performed using the free software and the proposed workflow. Thirteen guides were then printed to transfer the virtual planning information to the operating room. Conclusions: Virtual planning and the three-dimensional (3D) printing of guides for mandibular reconstruction is reliable with the aid of an in-hospital 3D laboratory. We also demonstrated that different guides with different shapes could be produced with benefits during surgery. Level of Evidence: 4 Laryngoscope, 2020.