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Condylar prostheses in head and neck cancer reconstruction
1Department of Otolaryngology, University of Minnesota, Box 396, Mayo Bldg, 420 Delaware St SE, Minneapolis, MN 55455, USA.
Archives of Otolaryngology--Head & Neck Surgery
|August 4, 2001
Summary
Metallic condylar prostheses pose significant risks for mandibular reconstruction after tumor resection. Complications like extrusion and hearing loss necessitate exploring autogenous materials, such as bone grafts, as safer alternatives.
Area of Science:
- Oral and Maxillofacial Surgery
- Oncology
- Reconstructive Surgery
Background:
- Mandibular resection for tumors often requires reconstruction.
- Metallic condylar prostheses are an option for restoring mandibular continuity.
Purpose of the Study:
- To evaluate the complications associated with metallic condylar prostheses used after mandibular resection for tumor.
- To compare the risks of metallic prostheses with alternative reconstruction methods.
Main Methods:
- A case series of four patients undergoing condylar reconstruction with metallic prostheses after hemimandibulectomy.
- A literature review was conducted to supplement the case series findings.
- Tertiary referral center setting.
Main Results:
- Complications observed included prosthesis exposure, extrusion, and migration.
- One patient experienced profound sensorineural hearing loss due to prosthesis migration into the epitympanum.
- Two patients required hardware removal, with one undergoing reconstruction using a fibular free flap.
Conclusions:
- Metallic condylar prostheses carry substantial risks in the context of tumor resection and reconstruction.
- Autogenous materials, particularly vascularized bone grafts, are recommended as a potentially safer alternative whenever feasible.
