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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
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Open Versus Closing Wedge Osteotomy and Application to Mandibular Reconstruction
Shirley Hu1, Jaclyn Klimczak1, Weylon Garner2
1Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic Surgery, Mount Sinai Medical Center, New York.
The Journal of Craniofacial Surgery
|April 14, 2020
Summary
This review compares closing wedge and open osteotomies for mandibular reconstruction. Open osteotomies are a viable option, especially for specific flap types in reconstructive surgery.
Area of Science:
- Surgical Techniques
- Mandibular Reconstruction
- Osteotomy
Background:
- Osteotomy techniques are crucial in mandibular reconstruction.
- Understanding the outcomes of different osteotomy methods is essential for surgical planning.
Purpose of the Study:
- To review closing wedge and open osteotomy techniques.
- To compare clinical and radiographic outcomes of these osteotomies.
- To apply findings to mandibular reconstruction.
Main Methods:
- Literature review across multiple surgical specialties.
- Databases searched include Ovid MEDLINE, EMBASE, and Google Scholar.
- Keywords used: 'osteotomy' and 'mandibular reconstruction'.
Main Results:
- Contrary to tradition, meta-analyses refute higher malunion rates for open osteotomies.
- Closing wedge osteotomies may risk perforator damage.
- No studies link osteotomy type to flap survival or wound healing.
Conclusions:
- Open osteotomies are a viable and preferred alternative.
- This is particularly true for flaps lacking consistent perforators, like scapular free flaps.
