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Morbidity after midline mandibulotomy and radiation therapy
M D Eisen1, G S Weinstein, A Chalian
1Department of Otorhinolaryngology--Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, USA.
American Journal of Otolaryngology
|October 14, 2000
Summary
Mandibulotomy surgery for oral and oropharyngeal cancers is safe, with low complication rates even when the surgical site receives postoperative radiation therapy. Shielding the mandibulotomy site showed a higher complication rate.
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Mandibulotomy is a surgical approach for oral and oropharyngeal neoplasms.
- Postoperative radiation therapy is often indicated but may increase surgical site morbidity.
Purpose of the Study:
- To evaluate the morbidity associated with mandibulotomy in cancer patients.
- To determine if radiation therapy to the mandibulotomy site increases complication risk.
Main Methods:
- Retrospective review of 30 patients undergoing midline mandibulotomy for oral cavity or oropharyngeal tumors.
- Analysis of complications based on whether the mandibulotomy site was irradiated or shielded.
- Median follow-up of 27.8 months.
Main Results:
- Low rates of wound infection (13%) and serious complications (7%) were observed.
- Osteoradionecrosis occurred in one patient; chronic drainage in another.
- Irradiating the mandibulotomy site had an 11% complication rate versus 30% for shielded sites.
Conclusions:
- Mandibulotomy is a safe procedure for patients requiring adjuvant radiation.
- Shielding the mandibulotomy site from radiation may increase complication risk.