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Definitive mandibular replacement using reconstruction plates.

J R Saunders1, R M Hirata, D A Jaques

  • 1Johns Hopkins Hospital, Baltimore, Maryland.

American Journal of Surgery
|October 1, 1990
PubMed
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Metal reconstruction plates offer a viable solution for mandibular defects after oral cancer surgery. This method achieved an 85% success rate in reconstruction, providing satisfactory functional and cosmetic outcomes for patients.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Surgical Oncology
  • Reconstructive Surgery

Background:

  • Radical cancer surgery for advanced oral cancer frequently results in significant mandibular defects.
  • Reconstructing these defects presents ongoing challenges for head and neck surgeons.
  • Current reconstructive techniques, such as microvascular transfer, have limitations.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of primary mandibular replacement using metal reconstruction plates without bone in patients with advanced oral cancer.
  • To compare this technique with traditional methods like microvascular transfer.

Main Methods:

  • Twenty-seven patients with advanced oral cancer underwent primary mandibular reconstruction using metal plates.
  • No bone grafts were used in conjunction with the metal plates.

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  • Patients were followed for an average of 19 months to assess reconstruction success, functional, and cosmetic results.

    • Main Results:

    • An initial success rate of 78% was observed, with primary soft tissue healing in 21 patients.
    • Six patients required plate removal due to postoperative complications.
    • An overall final mandibular reconstruction success rate of 85% was achieved, with 23 patients having successful reconstructions.

    Conclusions:

    • Primary mandibular replacement with metal reconstruction plates is a reasonable choice for immediate reconstructive needs in select patients with difficult tumors.
    • The technique demonstrates favorable operating times and donor site advantages compared to microvascular transfer.
    • Despite challenges like plate exposure, the overall success rate supports its use in managing mandibular defects.