[Mandibular reconstruction in oncology: discussion of indications]

The aim of the study was to assess the results of segmental mandibular resections and the validity of mandibular reconstructions. The medical records of 95 patients treated between January 1, 1987 and December 31, 1992 were reviewed. There were 82 (86%) carcinomas, 9 ameloblastomas and 4 sarcomas. Among the 82 patients treated for carcinoma, the overall 2- and 5-year survival rates were 70% and 33% respectively. The functional results evaluated one year after surgery showed no significant difference according to the reconstruction procedure: myocutaneous flap, osteomyocutaneous flap, titanium mandibular reconstruction plate or microsurgical transfer. The most important factor in functional rehabilitation is the amount of soft tissue resected. In head and neck oncology, aggressive surgical reconstruction of the mandible must only be used in patients with good general status and fair survival probability.