Commentary on: Three-Dimensional Custom-Made Surgical Guides in Facial Feminization Surgery: A Prospective Study on Safety and Accuracy

ABSTRACT Aim The aim of our study was to evaluate the advantages and disadvantages of three-dimensional (3D) plating system in the treatment of mid-face fractures. Patients and methods Thirty mid-face fractures in 18 patients at various anatomic locations were treated by open reduction and internal fixation using 3D plates. All patients were followed at regular intervals of 4th, 8th and 12th weeks respectively. Patients were assessed postoperatively for postoperative complication and occlusal stability. The incidence of neurosensory deficit, infection, masticatory difficulty, nonunion and malunion was also assessed. Results A significant reduction in fracture (72.2%) and occlusal stability (72.2%) was seen. The overall complication rate was (16.6%) which included two patients who developed postoperative paresthesia of lip, three patients had infection and two cases of masticatory difficulty which later subsided by higher antibiotics and 4 weeks of MMF. No evidence of nonunion and malunion was noted. Conclusion Single 3D titanium plates with 1.7 mm diameter holes and 1.7 mm screws were reliable and an effective treatment modality for mid-face fracture. Clinical significance Because of unique biogeometrical design owing to lesser amount of hardware material (fixation device) resulting into increased stability, the fixation in mid-face fractures is better in comparison to conventional 1.5 mm miniplate fixation. How to cite this article Singh M, Agrawal A, Chaudhary M, Kaur G, Harjani B, Yadav A. Use of Three-dimensional Plates in Mid-face Fracture: A Prospective Study. J Contemp Dent Pract 2015;16(7):571-577.

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Three-Dimensional Custom-Made Surgical Guides in Facial Feminization Surgery: Prospective Study on Safety and Accuracy

Aesthetic Surgery Journal ◽

10.1093/asj/sjab032 ◽

2021 ◽

Author(s):

Pierre Tawa ◽

Nicolas Brault ◽

Vlad Luca-Pozner ◽

Laurent Ganry ◽

Ghassen Chebbi ◽

...

Keyword(s):

Maxillofacial Surgery ◽

Three Dimensional ◽

Cerebrospinal Fluid Leak ◽

Mandibular Angle ◽

Virtual Planning ◽

Surgical Guides ◽

Sinus Wall ◽

Custom Made ◽

Cutting Guides ◽

Fluid Leak

Abstract Background Facial feminization surgery (FFS) includes several osseous modifications of the forehead, mandible and chin, procedures which require precision in order to provide the patient with a satisfactory result. Mispositioned osteotomies can lead to serious complications and bad aesthetic outcomes. Surgical cutting guides are commonly used in plastic and maxillofacial surgery to improve safety and accuracy. Yet, there is no report in the literature on the clinical application of cutting guides in FFS. Objectives The aim of this paper is to assess the safety and accuracy of custom surgical cutting guides in FFS procedures. Methods A prospective follow-up of forty-five patients regarding FFS with preoperative virtual planning and 3D custom-made surgical guides for anterior frontal sinus wall setback, mandibular angle reduction and/or osseous genioplasty was conducted. Accuracy (superimposing preoperative data on postoperative data by global registration with a 1 mm margin of error), safety (intradural intrusion for the forehead procedures and injury of the infra alveolar nerve for chin and mandibular angles) and patient satisfaction were assessed. Results A total of 133 procedures were documented. There was no cerebrospinal fluid leak on the forehead procedures nor any infra alveolar nerve or tooth root injury on both chin and mandibular angle operations (safety, 100%). Accuracy was 90.80 % on the forehead (n=25), 85.72% on the mandibular angles (n=44) and 96.20% on the chin (n=26). An overall satisfaction of 94.40% was recorded. Conclusions Custom-made surgical cutting guides could be a safe and accurate tool for forehead, mandibular angles and chin procedures for FFS.

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