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An approach to mandibular reconstruction
R M Pearl1, V LePore, V R Hentz
1Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, CA.
Annals of Plastic Surgery
|November 1, 1988
Summary
Optimal mandibular reconstruction involves careful planning, vascularized bone grafts, and surgical technique. This approach achieved high success rates in 38 patients, highlighting the importance of detailed surgical phases for best functional and aesthetic outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
- Biomaterials Science
Background:
- Mandibular reconstruction aims to restore both the form and function of the jaw.
- Achieving optimal outcomes necessitates a comprehensive approach encompassing multiple surgical and planning elements.
Observation:
- The study evaluated a specific approach to mandibular reconstruction in 38 patients.
- Key elements of the approach included proper preoperative planning, use of vascularized bone grafts, rigid fixation, flexible donor site selection, and restoration of oral sulci.
Findings:
- The described approach demonstrated a high success rate, with bony survival in 37 out of 38 patients and primary union in 35.
- A significant limitation was identified in cases involving extensive soft tissue and muscle loss due to tumor resection or trauma.
Implications:
- Meticulous attention to detail during preoperative, intraoperative, and postoperative phases is crucial for maximizing functional and aesthetic results in mandibular reconstruction.
- This reconstructive strategy offers a reliable solution for many patients, though challenges remain in complex cases with significant tissue defects.