Double barrel flap

[mauigna06]

Double barrel is possible with BRP in a feature branch: https://github.com/SlicerIGT/SlicerBoneReconstructionPlanner/issues/77#issue-1600136600

Interesting info supporting use of double barrel flaps: "The percentage of excess volume in fibular double-barrel grafts has not been reported. Our study showed that the percentage of patients who had a “good” result for a fibular single graft was only 13.8%, whereas the percentage who had a “good” result for a fibular double-barrel graft was 70.9%. The difference of bone height between grafted double-barrel fibula and native mandible was a minimum of −1.2 cm, and there were only 2 cases in which the difference was less than 1.0 cm. Shortage in bone height of a double-barrel fibular graft compared with the native mandible will not occur." "The bone height of the edentulous mandible is significantly low because the alveolar base is absorbed by tooth loss and the alveolar crest is flat. In our study, whether patients were dentulous or not had a large influence on the difference in bone height between the fibula and mandible and on clinical results, in fibular single graft and double-barrel graft. For mandibular reconstruction, dentulous patients mostly needed fibular double-barrel grafts, but the edentulous patients mostly needed fibular single grafts." Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010355/

[mauigna06]

The procedure is well described by his originator (1998) here: https://www.sciencedirect.com/science/article/abs/pii/S0278239198909144