(A653) Utility of 3D-Printed Cutting Guides in Improving Margin Status in Head and Neck Oncologic Surgery

Monday, October 13, 2025

12:00 PM - 1:00 PM EDT

Location: OTO EXPO, Posters

Presenting Author(s)

Abdullah AlShenaiber, BHSc

Medical Student
Temerty Faculty of Medicine, University of Toronto
Toronto, Ontario, Canada

Co-Author(s)

TC

Tanya Chen, MD

University of Toronto, United States
QF

Qwynn Ferreira, BE

Sinai Health, Department of Biomedical Engineering, United States
IW

Ian Witterick, MD, MSc, FRCSC

Surgeon-in-Chief
Sinai Health, Toronto
Toronto, Ontario, Canada
EM

Eric Monteiro, MD, MSc, FRCSC

Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, United States

Senior Author(s)

JD

Joel Davies, MD, MSc, FRCSC

Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, United States

Disclosure(s):

Abdullah AlShenaiber, BHSc: No relevant relationships to disclose.

Ian Witterick, MD, MSc, FRCSC: No relevant relationships to disclose.

Introduction: Margin status is a key prognosticator of survival in the surgical management of head and neck cancers. In advanced cases involving the mandible or maxilla, tumor visualization can pose significant challenges in predicting resection margins. This study evaluates the impact of a novel virtual surgical planning (VSP) technique using 3D-printed cutting guides in improving margin status during mandibular and maxillary resections.

Methods: This single-center prospective cohort study evaluated patients undergoing mandibulectomy or maxillectomy for oncologic resection from June 2020 to January 2025. Patients treated with VSP using 3D-printed cutting guides were compared to those undergoing conventional surgery. Cutting guides were created using CT-based volume rendering software and stereolithography printing, with planned bony and mucosal margins of 10mm. Baseline demographics, oncologic characteristics, pathology reports, and operative details were collected. Margins were classified as clear (>5mm), close (0.1-5mm), or positive ( < 0.1mm). Mucosal and bony margins were additionally compared at the microscopic level. Group comparisons were conducted using Chi-square or student's t-test for categorical and continuous variables, respectively.

Results: The VSP group (n=29) and conventional group (n=31) exhibited similar baseline and oncologic characteristics. The VSP group demonstrated significantly lower rates of overall positive margins (3% vs. 26%, p=0.02) including both mucosal margins (0% vs. 19%, p=0.01) and gross bony margins (0% vs. 13%, p=0.05). Within the VSP group, one patient had a positive microscopic bony margin (i.e. bone marrow). Mean operative time was significantly improved in the VSP group (610 minutes) compared to the conventional group (710 minutes) (p=0.01).

Conclusions: VSP with 3D-printed cutting guides improved margin status in mandibular and maxillary resections, underscoring its capability for enhancing surgical precision and potentially oncologic outcomes.