Week 7&8: Flap Weeks

     This week, I watched a mandible reconstruction using a free fibula flap headed by Dr. Spector. There were 3 surgery teams present: Head and neck, Oral, and Plastics. The team used a Fibula guide that was designed to fit the left fibula, connecting to the vessels in the right neck. The vessels came off the posterior of the reconstruction. The Fibula Cutting Guide used metal slot inserts. Marking walls with red dotted lines were used to mark the mid body cuts of the fibula. Total length of fibula needed for reconstruction was 60 mm. The dental implants were cylinders. The implant shelf is placed off the top surface of the implant. The preoperative anatomy and simulated postoperative anatomy was planned using Patient Specific Data and Virtual Surgical Planning (VSP) Reconstruction. Come to find out, you can live a productive life as an adult without a fibula since it is not the main load bearing bone.
     I also saw a craniotmy performed  by Dr. Theodore Schwartz to biopsy a tumor. The surgeons entered through the base of the skull using MRI as a guide. The patient had a young meningioma recurrence. The hardware from a previous surgery was removed to expose the previous bone flap. Most of the biopsy could be seen live on the OPMI Pentero. They put in mesh strips called Dura Guard to help close dura matter, prevent CSF leakage, and fusion to skull. They then prepped the old bone flap with hardware, added some DuraForm, and then screwed in the bone flap. Overall, it was nice to see a neurosurgery and another flap.