{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T10:11:05Z","timestamp":1774606265364,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T00:00:00Z","timestamp":1538524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>New advances in osseous microvascular mandibular rigid fixation are being employed at many institutions. These include standardized prebent\/preformed reconstruction plates as well as computer\u2010aided design\/computer\u2010aided manufacturing (CAD\/CAM) custom plates that are patient specific. Our goal was to assess and compare the outcomes of both of these new technologies when utilized for mandibular microvascular reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Subjects were categorized into two groups according to their mandibular rigid fixation technique: group 1\u2009=\u2009prebent\/preformed plates and group 2\u2009=\u2009CAD\/CAM custom plates. Primary outcome measures were 1) perioperative complications (defined as deep tissue infection, wound dehiscence resulting in bone exposure, and\/or plate exposure) and 2) reoperation rates for mandibular hardware failure\/explantation. Statistical analysis consisted of \u03c7<jats:sup>2<\/jats:sup>, Fisher exact test, and multivariable regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 142 subjects underwent microvascular mandibular reconstruction in a 6\u2010year period. Eighty\u2010nine subjects utilized prebent\/preformed plates, and 53 employed CAD\/CAM custom plates. Perioperative complications occurred in 32 of 89 (35.9%) subjects with prebent\/preformed plates and 11 of 53 (20.7%) subjects using CAD\/CAM custom plates. Reoperation requiring hardware explantation occurred in 18 of 89 (20.2%) subjects and three of 53 (5.6%) using CAD\/CAM custom plates. Statistical comparison of perioperative complications between the two groups approached significance (<jats:italic>P<\/jats:italic>\u2009=\u2009.0556), and the rate of reoperation was significant favoring CAD\/CAM implants (<jats:italic>P<\/jats:italic>\u2009=\u2009.0180).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In our experience, CAD\/CAM custom plates utilized for rigid fixation during microvascular mandibular reconstruction demonstrated fewer complications and statistically lower reoperation rates when compared with prebent\/preformed plates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2c <jats:italic>Laryngoscope<\/jats:italic>, 129:1081\u20131086, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27406","type":"journal-article","created":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T19:27:25Z","timestamp":1538767645000},"page":"1081-1086","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Comparison of Modern Rigid Fixation Plating Outcomes for Segmental Mandibular Microvascular Reconstruction"],"prefix":"10.1002","volume":"129","author":[{"given":"Adam C.","family":"McCann","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Kansas Medical Center  Kansas City Kansas U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yelizaveta","family":"Shnayder","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Kansas Medical Center  Kansas City Kansas U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojciech H.","family":"Przylecki","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery University of Kansas Medical Center  Kansas City Kansas U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiran","family":"Kakarala","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Kansas Medical Center  Kansas City Kansas U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niaman","family":"Nazir","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health University of Kansas Medical Center  Kansas City Kansas U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas A.","family":"Girod","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Kansas Medical Center  Kansas 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