Imaging for Jaw Reconstruction
Imaging has played an important part in the evolution in the approach to both tumour resection and jaw reconstruction. In terms of determination of bone invasion, previous reliance on physical examination and conventional radiography has been superseded with advances in single-photon emission computed tomography (SPECT) bone scintigraphy, MRI, and more recently PET/CT. This has allowed a more accurate preoperative planning of mandibular resection and a reduction in unnecessary segmental mandibulectomies. Furthermore, although we continue to perform the majority of our mandibular reconstructions at Chang Gung Memorial Hospital freehand and design the neomandibular construct in situ, advances in 3D CT planning may in the future allow the use of virtual surgery. This may allow a more accurate reconstruction of the mandible and minimise inter-operator variation in results, particularly in low-volume oncology centres.