Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Clinical Evaluation between Mandibulotomy and Mandible Sparing Approaches in Oropharyngeal Cancer Operation and Reconstruction

구인두암의 절제 및 재건수술에서 하악골 절개 접근법과 하악골 보존 접근법의 임상적 비교

  • Kim, Jeong Tae (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Lee, Jung Woo (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Jo, Dong In (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Lee, Hae Min (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University)
  • 김정태 (한양대학교 의과대학 성형외과학교실) ;
  • 이정우 (한양대학교 의과대학 성형외과학교실) ;
  • 조동인 (한양대학교 의과대학 성형외과학교실) ;
  • 이혜민 (한양대학교 의과대학 성형외과학교실)
  • Received : 2007.08.14
  • Published : 2008.03.10
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Abstract

Purpose: Mandibulotomy approach and mandible sparing approach are most common methods for oropharyngeal cancer surgery. Good surgical view and convenience of flap inset are advantages of mandibulotomy approach but deformity of mandible contour, postoperative malocclusion and radionecrosis are its limitations. To make up for the limitations, mandible sparing method is commonly performed, but limited surgical view and difficulties of flap inset are the weak points of this approach. The purpose of the study is to compare mandibulotomy and mandible sparing approaches in postoperative complications and progression of the treatment in oropharyngeal cancer operation and reconstruction. Methods: Single reconstructive microsurgeon operated for oropharyngeal cancer patients with different surgeons of head and neck department who prefer mandibulotomy and mandible sparing approach respectively, and we compared the frequency of postoperative complication, operation time, duration of hospitalization and recurrence rate between two different surgical approaches. Results: Mandibulotomy approach was used in 18 patients and mandible sparing approach was used in 15 patients. In mandibulotomy approach, there happened one case of teeth injury and one case of necrosis of skin and gingiva, but there happened no malocclusion and radionecrosis. In mandible sparing approach, there were 3 cases of fistula and 2 cases of infection which are significantly higher than mandibulotomy approach. There were no significant differences between early regional recurrence and duration of hospitalization. Conclusion: In this study we compared two different methods for the surgical approach in oropharyngeal cancer surgery. As mandible sparing approach has difficulties of limited surgical view, it can be used for the limited indications of anterior tongue and mouth floor cancer. Mandibulotomy approach has advantages of good surgical view and convenience of flap inset. In this method preservation of gingival tissue, watertight fashion suture, delicate osteotomy and plate fixation to maintain occlusion are the key points for the successful results.

Keywords

References

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