Evidence map›Paper›PMID 42573606›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

AI-driven morphometric comparison of fibula vs. iliac flap in mandibular reconstruction.

Chenyao Li, Yan Guo, Rong Yang, Xiaojun Chen, Shanyong Zhang

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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5 authors.

Chenyao Li *Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, No. 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China.
Yan Guo *Institute of Biomedical Manufacturing and Life Quality Engineering, School of Mechanical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Minhang District, Shanghai, 200240, China.
Rong YangDepartment of Oral Maxillofacial Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China. julien.7@hotmail.com.
Xiaojun ChenInstitute of Biomedical Manufacturing and Life Quality Engineering, School of Mechanical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Minhang District, Shanghai, 200240, China.
Shanyong ZhangDepartment of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, No. 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China.ORCID http://orcid.org/0009-0003-7879-3151

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare the clinical outcomes of vascularized free fibula flap (FFF) and deep circumflex iliac artery (DCIA) flap for mandibular reconstruction, using a novel AI-driven dual-modality system for quantitative 3D morphological fidelity and facial symmetry analysis.

methodsWe evaluated 56 patients with tumors (34 undergoing FFF and 22 undergoing DCIA) using a 3D U-Net deep learning model and Face Mesh. The U-Net model predicted mandibular shapes to generate patient-specific, anatomically plausible reference mandibles, and surface deviations were compared with the actual reconstructions. Facial symmetry was quantified using MediaPipe Face Mesh.

resultsNo significant differences in facial symmetry (S = 0.084 ± 0.013 vs. 0.083 ± 0.012, p = 0.781), functional recovery, or complications. DCIA showed lower morphological deviations for body defects: mean difference (1.42 ± 0.83 mm vs. 2.58 ± 0.62 mm, p = 0.001), maximum deviation (19.8 ± 2.7 mm vs. 21.4 ± 4.1 mm, p < 0.05).

conclusionFFF and DCIA flaps achieve comparable facial symmetry, functional recovery and complication rates in mandibular reconstruction. DCIA flap offers significantly improved 3D geometric accuracy only for isolated mandibular body defects, while the clinical relevance of this statistical difference remains uncertain. The AI-based quantitative assessment system established in this study provides an objective tool for defect-specific flap selection in mandibular reconstruction.

Indexed as

3D morphometric analysisArtificial intelligenceDeep circumflex iliac artery (DCIA) flapFibula free flapMandibular reconstruction

Identifiers

PMID42573606

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