Recent advances in reconstructive oral and maxillofacial surgery

Area of Science:

• Oral and Maxillofacial Surgery
• Reconstructive Surgery

Background:

• Head and neck reconstruction presents challenges due to complex defects and compromised tissue.
• Current gold standards, tissue grafts and vascularised flaps, have limitations including availability and donor site morbidity.

Purpose of the Study:

• To discuss current advances in head and neck reconstruction techniques.
• To highlight innovations improving accuracy, function, and aesthetics in reconstructive surgery.

Main Methods:

• Review of advancements including navigation, 3D imaging, stereolithographic models, and custom implants.
• Discussion of robotic surgery for oropharyngeal reconstruction.
• Exploration of tissue engineering, distraction osteogenesis, and facial allotransplantation.

Main Results:

• Technological developments enhance the accuracy of existing reconstructive methods.
• Robotic surgery facilitates complex oropharyngeal procedures without mandibulotomy.
• Tissue engineering and distraction osteogenesis offer alternatives to autologous tissue transfer.
• Facial allotransplantation enables whole-face replacement with functional recovery but requires lifelong immunosuppression.

Conclusions:

• Innovations in technology and surgical techniques are improving head and neck reconstruction.
• Tissue engineering, distraction osteogenesis, and allotransplantation represent significant, albeit specialized, advancements.
• Careful patient selection is crucial for advanced reconstructive modalities like facial allotransplantation.