Impact of virtual surgical planning and three-dimensional modeling on time to surgery in mandibular reconstruction by free fibula flap.

PURPOSE: Mandible reconstruction using a free fibula flap (FFF) is preferably performed with virtual surgical planning (VSP) to potentially improve functional and aesthetic outcomes. However, VSP is time-consuming. This study aims to assess the impact of VSP on time to surgery (TS). MATERIALS AND METHODS: All patients who underwent FFF for oral cavity cancer between 2007 and 2020 were included. Time to surgery (from the date of the first consultation to the surgery date) was compared between patients without VSP and with VSP. In our department, VSP and 3D modeling were performed by an external engineering laboratory. RESULTS: One hundred sixty-five patients were included retrospectively. VSP was utilized for 90 patients (55%). The mean time to surgery was 31 ± 16 days for patients undergoing conventional surgery without VSP and 44 ± 19 days for patients with VSP (p < 0.001). No clinical or tumoral characteristic were associated with a TS extended, except for the utilization of VSP (p < 0.001). By constituting groups of 25 consecutive patients, there is no difference in TS between the groups. CONCLUSION: The use of VSP significantly increased the time to surgery in our study, unrelated to clinical differences or year of surgery. This delay may have an impact on oncologic outcomes, so it should be considered in the care organization for each patient. Implementing new procedures to reduce this difference is warranted.

Laser Endoscopic Microsurgery of Laryngeal Cancers

Introduction: The aim of our study is to present our experience in treating laryngeal cancers with endoscopic CO2 laser surgery. Materials and Methods:  This retrospective study was conducted from January 2008 to December 2012 at Antoine Lacassagne Center of Nice. The functional and oncologic results of this surgical technique were analyzed and discussed. Results: The average length of hospital stay was 2.5 days. Phonatory results were considered excellent in 75% of our patients who maintained satisfactory phone communication skills after their interventions. Chronic hoarseness was the most common reason for bilateral or extended cordectomies. On the oncologic basis, histologic exam showed 90% of our margins were normal. The clinical control showed excellent laryngeal preservation in 94.23%. In 5 years, the overall survival was estimated at 96.15%. Conclusion: This study shows the benefit of the laser endoscopic microsurgery for the preservation of laryngeal functions and the local histologic control, essentially for early stage laryngeal cancers...