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Published on: January 12, 2019
Changes of the facial soft tissue after mandibular reconstruction using vascularized iliac flap
Mengkun Ding1, Chengqian Li1, Yifan Kang1
1Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
Objectives:
To reveal the change patterns of the facial soft tissue after applying mandibular reconstruction.
Materials And Methods:
16 Patients with mandibular benign tumor were recruited in this retrospective study. For all patients, segmental mandibular osteotomy and concurrent reconstruction using vascularized iliac flap were conducted. The soft tissue thickness of patients' lower face was measured with CT scans before surgery, 1 week, 6 months and 1 year after surgery. The time-dependent changes of tissue thickness were analyzed.
Results:
The most significant tissue swelling was 28.86%, at 1 week after the surgery. The average increase of tissue thickness was 4.78 ± 5.30 mm across patient. After 1 year of the surgery, tissue thickness decreased to the level before operation or the level of the healthy side. The thickness of the low-density tissue fluctuated mildly, while the thickness of the high-density tissue fluctuated significantly. The disuse atrophy of the masseter occurred 1 week after the surgery, and was reversed after 1 year. The removal of the submandibular gland caused depression in submandibular area, which intensified over time.
Conclusion:
Across patients, soft tissue thickness in the lower face after mandibular osteotomy and reconstruction increased significantly 1 week after the surgery, and decreased over time. After 1 year, tissue thickness went back to the pre-surgery level, where matched up with the healthy side.
Clinical Relevance:
We documented the change patterns of the facial soft tissue after mandibular reconstruction. These results can help improve the planning of virtual surgeries and the timing for aesthetic assessment.
Trial Registration:
ClinicalTrials.gov Identifier: ChiCTR2100054103.
