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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
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Classification of mandible defects and algorithm for microvascular reconstruction.

Benjamin D Schultz1, Michael Sosin, Arthur Nam

  • 1Baltimore, Md.; and New York, N.Y. From the Division of Plastic, Reconstructive and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center; the Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine; the University of Maryland School of Medicine; and the Department of Plastic Surgery, New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery.

Plastic and Reconstructive Surgery
|March 27, 2015
PubMed
Summary
This summary is machine-generated.

This study introduces a new classification system for composite mandibular tissue loss, aiding in microvascular reconstruction. The developed algorithm provides a reliable method for treating these complex defects.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Microsurgery
  • Reconstructive Surgery

Background:

  • Composite mandibular tissue loss causes significant functional and cosmetic deficits.
  • Microvascular reconstruction is a key treatment modality for these defects.
  • A novel classification system and treatment algorithm were developed to standardize care.

Observation:

  • A retrospective review identified 24 patients undergoing microvascular composite mandibular reconstruction.
  • Defects were classified into four types based on location and extent.
  • Type 2 defects, unilateral and extending beyond the mandibular angle, were most common.

Findings:

  • The study developed and applied a treatment algorithm based on the new classification system.
  • Fibula flaps were predominantly used for reconstruction (n=19), followed by iliac crest flaps (n=5).
  • Complications included infection, partial flap necrosis, plate fracture, dehiscence, and microvascular thrombosis.

Implications:

  • This classification system offers a consistent and reliable approach to managing composite mandibular defects.
  • The algorithm guides reconstructive strategies by considering defect characteristics and donor flap options.
  • Improved outcomes in functional and cosmetic restoration are anticipated with standardized treatment.