Rhytidectomy approach for mandibular reconstruction with microvascular free flaps after resection of mandibular benign tumors.
OBJECTIVE
Microvascular surgery has become the preferred method for mandibular reconstruction. A neck incision frequently is required for malignant tumor resections to carry out the dissection. The authors suggest a rhytidectomy approach for mandibular reconstruction with microvascular free flaps after the resection of benign tumors.


METHODS
Seven patients with lateral mandibular defects resulting from resection of benign mandibular tumors were treated in the author's department. A combined rhytidectomy approach with an intraoral incision was used for mandibular resection and reconstruction of the defects using vascularized free osseous flaps.


RESULTS
The study was comprised of 3 men and 4 women with a mean age of 37.57 years (range, 28 to 50 years). Follow-up ranged from 9 to 87 months after surgery (mean, 56.28 months). The iliac crest was used for reconstruction in 6 patients, whereas the fibula was used in 1 patient. Transient paresis of the marginal nerve was observed in 2 patients. Flap loss occurred in 1 patient and required repeat microvascular reconstructive surgery. Dental rehabilitation with osseointegrated implants was performed in 4 patients. At the end of the follow-up period, successful mandibular reconstruction was achieved in all patients. Functional outcome was regarded as excellent in all patients, whereas esthetic outcome was judged excellent in 6 patients and good in 1 patient.


CONCLUSIONS
A rhytidectomy approach combined with an intraoral incision for microvascular mandibular reconstruction after the resection of benign tumors is a feasible technique that provides good exposure of the anatomic structures, an inconspicuous facial scar, and adequate facial contour and symmetry. Excellent clinical results are reported with the use of this technique, which should be included in the surgical armamentarium for mandibular reconstruction.
Staff Surgeon, Oral and Maxillofacial Surgery Unit, Department of Pediatric Surgery, University Hospital Sant Joan de Déu, Barcelona, Spain.
Eloy-Miguel
EM
García-Díez
Gui-Youn
GY
Cho-Lee
Javier-Mauricio
JM
Raigosa-García
Ramón
R
Sieira-Gil
Carles
C
Martí Pagès
D000328:Adult; D000564:Ameloblastoma / Q000473:pathology / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods; D003758:Dental Implantation, Endosseous / Q000379:methods; D005152:Facial Muscles / Q000601:surgery; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000473:pathology / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000379:methods*; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D015361:Rhytidoplasty / Q000379:methods*