Replacement of tumor-involved mandible by cryosurgically devitalized autograft: human experience

In management of a malignant floor-of-mouth tumor invading the mandible, the mandible is the main focus of reconstruction and the most likely site of rehabilitative failure. Creation of a functional and cosmetically appealing replacement is a major therapeutic goal. In canines, neoosteogenesis does occur in mandibular autografts exposed to two consecutive freeze-thaw cycles prior to reimplantation. Also postoperative radiotherapy in canines does not elicit a higher incidence of complications or promote failure of the mandibular autograft to reconstitute itself. This technique was used in a 52-year-old man with a large lesion in the anterior floor of the mouth extending into the inner cortex of the mandible. The theoretical advantages of nonantigenicity and excellence of mandibular configuration are obvious. That there are important pitfalls that may lead to reconstructive failure is equally obvious.