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The mandibular split involves an esthetically unpleasant bipartition of the lower lip and is prone to bony non-union or sequestration. The conventional pull-through technique on the other hand lacks the secure reattachment of the lingually released soft tissues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The feasibility of a new modified pull-through approach was tested on three anatomical specimens. CAD\/CAM cutting guides were used to design a retentive bone flap to properly refixate the genioglossus and geniohyoid muscles after the procedure. The radiographic assessment and treatment planning was performed on 12 cadavers. The entire procedure was tested surgically via dissection in three of those cases. This procedure was then applied in a clinical case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Precise repositioning and dynamic compression of bony segments was possible reproducibly and without injury to adjacent structures. In all dissected cases, a median lingual foramen was found and in two cases vessels entering it could be dissected Radiologic anatomical landmarks were sufficient in all 12 cases to perform the clinical planning procedure. Clinically, the osteotomized segment demonstrated good blood supply and plateless repositioning was verified postoperatively via cone beam scan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The method presented is safe and easy to perform. Individual cutting guides improve the safety and accuracy of the procedure, potentially eliminating the need for osteosynthesis. We provide the anatomical and radiologic basis for clinical evaluation of this pedicled bone flap procedure and present the clinical application of this modified pull-through approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00276-024-03302-3","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T15:02:21Z","timestamp":1708009341000},"page":"341-352","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A modified pull-through approach with a pedicled bone flap for oral and oropharyngeal cancer resection: a feasibility study"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5477-623X","authenticated-orcid":false,"given":"Norbert","family":"Neckel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1976-0512","authenticated-orcid":false,"given":"Peter H.","family":"Neckel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard","family":"Hirt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Doll","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Hofmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Nahles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"Heiland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kilian","family":"Kreutzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Koerdt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"issue":"7","key":"3302_CR1","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1016\/j.bjoms.2020.01.010","volume":"58","author":"Q You","year":"2020","unstructured":"You Q, Jing X, Fan S, Wang Y, Yang Z (2020) Comparison of functional outcomes and health-related quality of life one year after treatment in patients with oral and oropharyngeal cancer treated with three different reconstruction methods. 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KLS Martin GmbH provided technical support for the design and manufacturing of the patient-specific cutting guides. The production costs of the cutting guide used for the clinical application was financed by the AO CMF Start-up Grant received by Elena Hofmann, Norbert Neckel, Kilian Kreutzer and Steffen Koerdt (Grant number:  AOCMFS-23-15H-Hofmann).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The anatomical procedures were approved by the Ethics Committee of the Eberhard Karls Universit\u00e4t T\u00fcbingen, Germany (Project Nr. 081\/2022BO2) and the clinical application was approved by the Ethics Committee of the Charit\u00e9 Universit\u00e4tsmedizin Berlin, Germany (EA2\/305\/20).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The body donors gave informed consent to use their cadavers for research purposes in accordance with the Declaration of Helsinki including participation and publication.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate and publish"}}]}}