Cheek-splitting technique for marginal mandibulectomy: A novel approach

Area of Science:

• Oncology
• Surgical Oncology
• Oral and Maxillofacial Surgery

Background:

• Marginal mandibulectomy requires complete tumor removal and prevention of mandibular fracture.
• Acute angle resections in the molar region can lead to pathological fractures.
• Submandibular or transbuccal approaches are necessary for marginal mandibulectomy without acute angles.

Observation:

• The transbuccal approach offers advantages over the submandibular approach, including reduced operative time and preservation of facial and mental nerves.
• This approach avoids scarring in the surgical field, facilitating subsequent neck dissection.
• Two cases of lower gingival carcinoma were treated using an improved cheek-splitting technique with a transbuccal approach.

Findings:

• The improved cheek-splitting technique, considering oral angle, flap design, and modiolus, resulted in satisfactory aesthetic outcomes.
• The transbuccal approach effectively addressed lesions in the molar or posterior mandible.
• Complete tumor removal and prevention of iatrogenic fractures were achieved.

Implications:

• This technique offers a viable option for marginal mandibulectomy in lower gingival carcinoma, balancing oncological and aesthetic goals.
• The transbuccal approach may be a preferred method for specific mandibular tumor resections.
• Further research could explore long-term outcomes and broader applications of this technique.