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

AI / informaticsEuropean 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· Aug 2026

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

Chenyao Li, Yan Guo, Rong Yang … Shanyong Zhang

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Microsurgery & FlapsAI / informaticsQ2IF 2.5

Iliac artery flap shows smaller mandibular shape deviation than fibula flap for body defects

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

Chenyao Li … Shanyong Zhang

European archives of oto-rhino-laryngology · Aug 2026 · Q2 in General Medicine

Purpose

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

Methods

We evaluated 56 patients with tumors (34 undergoing free fibula flap and 22 undergoing deep circumflex iliac artery) using a 3D U-Net deep learning model and Face Mesh.

n = 56 patients

Results

iliac flap shapes mandible closer to the ideal, less deviation than fibula

DCIA (body defect mean

1.42mm

FFF (body defect mean

2.58mm

“

Conclusion · 1 of 3

Free fibula flap and deep circumflex iliac artery flaps achieve comparable facial symmetry, functional recovery and complication rates in mandibular reconstruction.

Conclusion · 2 of 3

deep circumflex iliac artery flap offers significantly improved 3D geometric accuracy only for isolated mandibular body defects, while the clinical relevance of this statistical difference remains uncertain.

Conclusion · 3 of 3

The AI-based quantitative assessment system established in this study provides an objective tool for defect-specific flap selection in mandibular reconstruction.

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

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

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