{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:49:45Z","timestamp":1786978185191,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"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":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Assess the long\u2010term plate complications with patient\u2010specific plates (PSPs) created with computer\u2010aided design (CAD) and computer\u2010aided manufacturing (CAM) for fibula free flap reconstructions for mandibular defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective chart review from January 2010 to July 2022 of patients who underwent mandibular reconstruction with a fibula free flap and PSP. Primary outcome was plating\u2010related complications, defined as plate exposure, fracture, loose screws, and plate removal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 221 patients underwent PSP fibula reconstruction. Average age was 59.8\u2009+\u200914.3\u2009years old with male to female ratio of 2:1. Squamous cell carcinoma of the mandible was the most common reason for resection, 47.5%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009105. Plate removal occurred in 11% of patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925) about 17.4\u2009months after the initial surgery. Plates were removed due to exposure (76%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919) or screw loosening (24%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096). Malignancy was associated with an increased risk of plate complications when compared to benign tumor (odds ratio [OR] 9.04, confidence interval [CI] 1.36\u20133.85), osteonecrosis (OR 1.38, CI 0.59\u20133.48), and trauma (OR 1.26, CI 0.23\u201312.8). Postoperative radiation therapy (OR 2.27, CI 1.07\u20134.82,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026) and surgical site infection (OR 9.22, CI 4.11\u201321.88,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) were associated with more plate complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CAD creates PSPs that remain stable in the majority of patients over the long term. Plate removal is less compared to non\u2010PSP reconstruction. Consideration of the soft tissue envelope over the plate and management of perioperative infection at the time of surgery should be entertained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      4\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 134:4929\u20134934, 2024\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.31640","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T06:45:05Z","timestamp":1721198705000},"page":"4929-4934","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Long\u2010Term Plate Complications in Patient\u2010Specific Plates Utilizing Computer\u2010Aided Design"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8949-1421","authenticated-orcid":false,"given":"Sara","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Oregon Health and Science University  Portland Oregon U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoey","family":"Morton","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mackenzie","family":"Sautter","sequence":"additional","affiliation":[{"name":"Department of Oral Maxillofacial Surgery Oregon Health Science University  Portland Oregon U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8552-0467","authenticated-orcid":false,"given":"Gavin","family":"Young","sequence":"additional","affiliation":[{"name":"Oregon Health Science University School of Medicine  Portland Oregon U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Petrisor","sequence":"additional","affiliation":[{"name":"Department of Oral Maxillofacial Surgery Oregon Health Science University  Portland Oregon U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasa R.","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Oral Maxillofacial Surgery Oregon Health Science University  Portland Oregon U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark K.","family":"Wax","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Oregon Health and Science 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