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Median mandibulotomy: a critical assessment
1Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
Head & Neck
|September 1, 1991
Summary
Median mandibulotomy is a preferred surgical approach for oral tumors when normal tissue is present. This technique offers good outcomes, with most patients experiencing uncomplicated recovery and no bone nonunion.
Area of Science:
- Otolaryngology
- Head and Neck Surgery
- Surgical Oncology
Background:
- Median mandibulotomy (mandibular swing) is increasingly used for oral and oropharyngeal tumor access.
- It is also beneficial for deep lobe parotid and parapharyngeal space tumors.
Purpose of the Study:
- To review the authors' experience with 313 mandibulotomies performed between 1959 and 1988.
- To analyze indications, complications, and technique modifications.
Main Methods:
- Retrospective review of 313 mandibulotomy cases.
- Analysis of surgical indications, complications, and outcomes.
- Evaluation of technique modifications including paramedian osteotomy and miniplate fixation.
Main Results:
- Most patients (80%) had uncomplicated recoveries.
- Osteotomy-related complications occurred in 20% but were generally minor; no nonunions were recorded.
- Preoperative dental assessment and selective use of dental splints improved postoperative occlusion.
Conclusions:
- Median mandibulotomy is a safe and effective surgical approach for selected head and neck tumors.
- Technique modifications like paramedian osteotomy and miniplate fixation may reduce complications.
- Careful patient selection and preoperative dental management are crucial for optimal outcomes.