Modified Mandibulotomy Technique to Reduce Postoperative Complications: 5-Year Results
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Purpose: To review the 5-year outcomes of our modified mandibulotomy technique. Retrospective review of a tertiary level oral cancer center. Materials and Methods: During a 5-year period, 30 patients who had a uniform surgical technique consisting of a lower lip-splitting, modified stair-step osteotomy with thin saw blade and osteotome after plate-precontouring and combination fixation with monocortical osteosynthesis (miniplate) and bicortical osteosynthesis (maxiplate and bicortical screws), with at least 14 months postoperative follow-up, were selected and reviewed retrospectively. Results: There were 8 women and 22 men with an average age of 56.5 years. All the patients involved malignancies were squamous cell carcinoma. The main primary sites of the those who underwent a mandibulotomy were the tonsil, the base of tongue, the oral tongue, the retromolar pad area, and others. Others included buccal cheek, floor of mouth, and soft palate. 23 patients received postoperative radiation therapy, and among whom 8 patients also received chemotherapy. Total four (13%) mandibulotomy-related complications occurred, only two (6.7%) requiring additional operation under general anesthesia. Conclusion: Our modified mandibulotomy meets the criteria for an ideal mandibulotomy technique relatively well because it requires no intermaxillary fixation,can precise preserve the occlusion in a precise way, allows early function, requires no secondary procedures, and has few complications.
Abstract
Purpose: To review the 5-year outcomes of our modified mandibulotomy technique. Retrospective review of a tertiary level oral cancer center. Materials and Methods: During a 5-year period, 30 patients who had a uniform surgical technique consisting of a lower lip-splitting, modified stair-step osteotomy with thin saw blade and osteotome after plate-precontouring and combination fixation with monocortical osteosynthesis (miniplate) and bicortical osteosynthesis (maxiplate and bicortical screws), with at least 14 months postoperative follow-up, were selected and reviewed retrospectively. Results: There were 8 women and 22 men with an average age of 56.5 years. All the patients involved malignancies were squamous cell carcinoma. The main primary sites of the those who underwent a mandibulotomy were the tonsil, the base of tongue, the oral tongue, the retromolar pad area, and others. Others included buccal cheek, floor of mouth, and soft palate. 23 patients received postoperative radiation therapy, and among whom 8 patients also received chemotherapy. Total four (13%) mandibulotomy-related complications occurred, only two (6.7%) requiring additional operation under general anesthesia. Conclusion: Our modified mandibulotomy meets the criteria for an ideal mandibulotomy technique relatively well because it requires no intermaxillary fixation,can precise preserve the occlusion in a precise way, allows early function, requires no secondary procedures, and has few complications.
참고문헌 (25)
- Butlin HT, "Diseases of the tongue", pp.331~ (1885), Cassell
- Martin H, "Median labiomandibular glossotomy. Trotter’s median (anterior) translingual pharyngotomy", Am J Surg, 102, pp.753~759 (1961)
- McGregor IA, "Mandibular osteotomy in the surgical approach to the oral cavity", Head Neck Surg, 5, pp.457~462 (1983)
- Davidson J, "Mandibulotomy in the irradiated patient", Arch Otolaryngol Head Neck Surg, 115, pp.497~499 (1989)
- Davidson J, "Mandibulotomy and radical radiotherapy: compatible or not?", J Otolaryngol, 17, pp.279~281 (1988)
- McCann KJ, "Complications associated with rigid fixation of mandibulotomies", J Otolaryngol, 23, pp.210~215 (1994)
- Spiro RH, "Mandibular “swing” approach for oral and oropharyngeal tumors", Head Neck Surg, 3, pp.371~378 (1981)
- Sullivan PK, "Mandibular osteotomies for tumor extirpation: the advantages of rigid fixation", Laryngoscope, 102, pp.73~80 (1992)
- Shah JP, "Comparative evaluation of fixation methods after mandibulotomy for oropharyngeal tumors", Am J Surg, 166, pp.431~434 (1993)
- Singh AM, "Anterior mandibulotomy for oral and oropharyngeal tumours", J Laryngol Otol, 107, pp.316~319 (1993)
- Altman K, "Non-union of mandibulotomy sites following irradiation for squamous cell carcinoma of the oral cavity", Br J Oral Maxillofac Surg, 34, pp.62~65 (1996)
- Amin MR, "Straight midline mandibulotomy revisited", Laryngoscope, 109, pp.1402~1405 (1999)
- Aslan G, "Modified mandibulotomy approach to tumors of the oropharynx", Ann Plast Surg, 46, pp.77~79 (2001)
- Flood TR, "A modified surgical approach for parapharyngeal space tumours: use of the inverted ‘L’ osteotomy", Br J Oral Maxillofac Surg, 29, pp.82~86 (1991)
- Jungehuelsing M, "Modifications of the midline mandibulotomy for access to the parapharyngeal space", Laryngoscope, 120, pp.1557~1562 (2010)
- Sardi A, "Modified mandibular swing procedure for resection of carcinoma of the oropharynx", Head Neck, 13, pp.394~397 (1991)
- Cohen JI, "The mandibular swing stabilization of the midline mandibular osteotomy", Laryngoscope, 98, pp.1139~1142 (1988)
- Carraway JH, "Restoration of mandibular continuity after symphyseal osteotomy", Br J Plast Surg, 34, pp.392~394 (1981)
- Dziegielewski PT, "The mandibulotomy: friend or foe? Safety outcomes and literature review", Laryngoscope, 119, pp.2369~2375 (2009)
- Kolokythas A, "Mandibular osteotomies for access to select parapharyngeal space neoplasms", Head Neck, 31, pp.102~110 (2009)
- Nam W, "Contributing factors to mandibulotomy complications: a retrospective study", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 101, pp.e65~e70 (2006)
- Nam W, "Modified mandibulotomy technique to reposition the hemimandibular segments", J Oral Maxillofac Surg, 65, pp.1433~1435 (2007)
- Engroff SL, "Mandibulotomy fixation: a laboratory analysis", J Oral Maxillofac Surg, 61, pp.1297~1301 (2003)
- Dubner S, "Median mandibulotomy: a critical assessment", Head Neck, 13, pp.389~393 (1991)
- Dziegielewski PT, "The lip-splitting mandibulotomy: aesthetic and functional outcomes", Oral Oncol, 46, pp.612~617 (2010)
