Mandibular reconstruction with local live vascularised bone transfer

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Oncology
• Reconstructive Surgery

Background:

• Mandibular reconstruction is crucial after trauma or tumor ablation in the head and neck.
• Various techniques exist, ranging from complex vascularised bone grafts to alloplastic materials.
• The choice of technique depends on defect complexity, available resources, and patient condition.

Purpose of the Study:

• To describe sliding osteotomies for mandibular reconstruction using vascularised live-bone grafts.
• To evaluate the effectiveness and outcomes of sliding mandibulectomy for malignant tumor ablation defects.
• To analyze complications, failures, and success rates of this reconstructive method.

Main Methods:

• Description of different sliding osteotomy techniques for harvesting live bone flaps.
• Application of these techniques for primary mandibular reconstruction in 18 cases.
• Analysis of complications, failures, and success rates associated with sliding mandibulectomies.

Main Results:

• Sliding mandibulectomy successfully provided primary skeletal support in 18 cases.
• The technique is suitable for short mandibular defects (up to 9 cm) and patients with poor prognoses.
• Detailed analysis of complications, failures, and success rates was performed.

Conclusions:

• Sliding mandibulectomy is a viable and simpler option for specific mandibular defects, particularly in compromised patients.
• Vascularised live-bone grafts harvested via sliding osteotomies can effectively reconstruct the mandible.
• The study provides insights into the outcomes and considerations for employing sliding mandibulectomy.