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Contributing factors to mandibulotomy complications: a retrospective study
Woong Nam1, Hyung-Jun Kim, Eun-Chang Choi
1Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea.
Summary
This study found that rigid monocortical and bicortical plate fixation reduces mandibulotomy complications. Perioperative radiation and infection increase risks, necessitating careful management.
Area of Science:
- Oral and Maxillofacial Surgery
- Surgical Oncology
- Head and Neck Cancer Reconstruction
Background:
- Mandibulotomies are crucial surgical procedures for oral cavity and oropharyngeal tumors.
- Understanding and mitigating complications are vital for patient outcomes.
Purpose of the Study:
- To investigate complications associated with mandibulotomies.
- To identify factors contributing to these complications.
Main Methods:
- Retrospective review of 103 patients undergoing mandibulotomy.
- Analysis of variables including osteotomy type, fixation, radiation, and chemotherapy.
Main Results:
- 18.4% of patients experienced complications, including nonunion and osteoradionecrosis.
- Rigid monocortical and bicortical plate fixation (MCP + BCP) showed statistical significance in reducing complications (P < .05).
- Preoperative radiotherapy and chemotherapy were associated with increased postoperative complications.
Conclusions:
- Paramedian stair-step osteotomy with thin saw blades is recommended for improved reapproximation and minimal bone loss.
- Rigid MCP + BCP fixation is advantageous for preventing postoperative complications.
- Careful management of perioperative radiation and infection is crucial to decrease complication rates.