Updates in Head and Neck Reconstruction.

Learning Objectives: After reading this article, the participant should: 1. have a basic understanding of virtual planning, rapid prototype modeling, 3D printing, and computer-assisted design and manufacture, 2. understand the principles of combining virtual planning and vascular mapping, 3. understand principles of flap choice and design in preoperative planning of free osteocutaneous flaps in mandible and midface reconstruction, and 4. discuss advantages and disadvantages of computer-assisted design and manufacture in reconstruction of advanced oncologic mandible and midface defects. Summary: Virtual planning and rapid prototype modeling is increasingly employed in head and neck reconstruction with the aim of achieving superior surgical outcomes in functionally and aesthetically critical areas of the head and neck compared to conventional reconstruction. The reconstructive surgeon must be able to understand this rapidly-advancing technology with its advantages and disadvantages. There is no limit to the degree to which patient-specific data may be integrated into the virtual planning process. For example, vascular mapping can be incorporated into virtual planning of mandible or midface reconstruction. Representative mandible and midface cases are presented to illustrate the process of virtual planning. Although virtual planning has become helpful in head and neck reconstruction, its routine may be limited by logistic challenges, increased acquisition costs, and limited flexibility for intraoperative modifications. Nevertheless, the authors believe that the superior functional and aesthetic results realized with virtual planning outweigh the limitations. (C)2017American Society of Plastic Surgeons