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["Conservative" transmandibular buccopharyngectomy].

S Orsel1, J P Bessède, J P Sauvage

  • 1C.H.U. Dupuytren, Service O.R.L., Limoges, France.

Revue De Laryngologie - Otologie - Rhinologie
|January 1, 1992
PubMed
Summary
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Transmandibular buccopharyngectomy (TMBP) for amygdaline region tumors often causes significant esthetic and functional deficits. A mandibular conservation technique using vertical osteotomy and titanium plates offers a reliable alternative with good patient outcomes.

Area of Science:

  • Head and Neck Surgery
  • Surgical Oncology
  • Oral and Maxillofacial Surgery

Context:

  • Traditionally, amygdaline region tumors were treated with transmandibular buccopharyngectomy (TMBP), involving mandibular angle sacrifice.
  • This radical approach, while facilitating surgery, resulted in considerable esthetic and functional impairments.
  • Early attempts at mandibular reconstruction post-TMBP using steel wires were complicated by osteitis.

Purpose:

  • To evaluate the efficacy and safety of a mandibular conservation technique for amygdaline region tumors.
  • To compare outcomes with the traditional transmandibular buccopharyngectomy (TMBP) approach.
  • To assess the esthetic and functional results, as well as complication rates, of the conservation technique.

Summary:

  • A mandibular conservation technique involving vertical paramedian osteotomy anterior to the mental nerve and osteosynthesis with titanium plates was adopted.

Related Experiment Videos

  • This technique, published by Gehanno and Beauvillain in 1989, was applied to 8 patients over 18 months.
  • The study reported no cases of osteitis and achieved favorable esthetic and functional results.
  • Impact:

    • The mandibular conservation technique offers a reliable, carcinologically safe, and technically straightforward alternative to TMBP for amygdaline region tumors.
    • This approach significantly reduces the esthetic and functional morbidity associated with mandibular angle sacrifice.
    • The technique demonstrates potential for improved patient quality of life following oncologic surgery in this region.