Nonrigid Reconstruction of the Mandible

Abstract

\s=b\Immediate rigid reconstruction of sacrificed portions of the mandible is desirable, but experience has shown that as many as 50% of bony or alloplastic implants are ultimately rejected or removed within the first few months after reconstruction. Functional and cosmetic reconstruction of the mandible, floor of the mouth, and, where necessary, skin of the lower lip and chin can be achieved with various local and myocutaneous flaps, to be followed after approximately 1 year by secondary bony reconstruction with a significantly lower complication rate. We describe the results in 43 patients treated by this approach.(Arch Otolaryngol Head Neck Surg. 1989;115:1190-1192 When undertaking major ablative procedures for cancer of the head and neck, the surgeon should strive to restore the patient to struc¬ ture and function as close to normal as possible. If this can be performed successfully in a single stage so that there is no need for more than the original extirpative procedure, it is clearly in the patient's best interest to

Osteocutaneous free flaps for mandibular reconstruction: systematic review of their frequency of use and a preliminary quality of life comparison

“…18 Criteria for the ideal reconstructive option for segmental mandibulectomy are that it should restore bone continuity and oral competency, maintain occlusion, permit dental restoration, and restore facial symmetry and contours. 19 Wound closure should be immediate and complete, and complications such as orocutaneous fistula, infection, and dehiscence or plate exposure should be avoided. 20 The main reconstructive options are a non-vascularised bone graft, a reconstruction plate alone or with a soft tissue flap, a soft tissue pedicled flap, a soft tissue free flap, or an osteocutaneous free flap with a reconstruction plate.…”

“…In contrast, extensive lateral defects lead to shifting of the mandible, resulting in pain and malocclusion 18 . Criteria for the ideal reconstructive option for segmental mandibulectomy are that it should restore bone continuity and oral competency, maintain occlusion, permit dental restoration, and restore facial symmetry and contours 19 . Wound closure should be immediate and complete, and complications such as orocutaneous fistula, infection, and dehiscence or plate exposure should be avoided 20 .…”