Evaluation of aesthetic outcomes of mandibular reconstruction using artificial intelligence

• Published in: Head & neck 2024-11, Vol.46 (11), p.2699-2708
• Main Authors: Hidaka, Takeaki, Miyamoto, Shimpei, Furuse, Kiichi, Fukunaga, Yutaka, Oshima, Azusa, Matsuura, Kazuto, Higashino, Takuya
• Format: Article
• Language: English
• Subjects: Adult; aesthetics; Aged; Artificial Intelligence; Asymmetry; Bone grafts; Bone Plates; Bone Transplantation - methods; Esthetics; Female; Humans; Male; Mandible; Mandible - surgery; mandibular reconstruction; Mandibular Reconstruction - methods; mandibular reconstruction plate; Middle Aged; outcome assessment; Pattern recognition; Plastic Surgery Procedures - methods; Retrospective Studies; Surgical Flaps - blood supply; Treatment Outcome; vascularized bone grafts; Young Adult
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.27797

Background Although vascularized bone graft (VBG) transfer is the current standard for mandibular reconstruction, reconstruction with a mandibular reconstruction plate (MRP) and with a soft‐tissue flap (STF) alone remain crucial options for patients with poor general conditions. However, objective aesthetic outcome evaluations for these methods are limited. Methods In a retrospective analysis of 65 patients (VBG, 33; MRP, 19; and STF, 13), mandibular asymmetry value was calculated for each patient's photograph using facial recognition AI, with a higher value indicating worse asymmetry. Results The MRP group had a value comparable to the VBG group regardless of mandibular defect types. The STF group had a significantly higher value than the VBG group. Conclusions Regarding cosmesis, STF was inferior to VBG, whereas MRP was comparable to VBG, even for anterior defects for which rigid reconstruction is mandatory. However, MRP's risks of plate‐related complications limit its use to cases where VBG is contraindicated or with poor prognosis. Level of Evidence 4.