Mandibular reconstruction in head and neck cancer: which is the gold standard?

Abstract

INTRODUCTION:

The aim of this study is to perform a systematic review to compare the outcomes of the different surgical options for mandibular reconstruction in head and neck cancer.

MATERIAL AND METHODS:

93 articles were selected. Four groups were identified: titanium plate without flaps, titanium plate covered by soft tissue flap, bone tissue flaps and double flaps. We compared patients' characteristics, site of mandibulectomy, type of reconstruction and complications.

RESULTS:

4697 patients were reported. The groups were not homogeneous regarding the type of defect and the treatment history. A significant difference in terms of post-operative complications was found between group 1 and group 2 (p < 0.00001), and between group 2 and group 3 (p < 0.00001). Total complications rate for group 4 was significantly higher when compared to group 3 (p < 0.00001), but no significant difference was found with group 2.

CONCLUSION:

These results suggest that mandibular reconstruction using a microvascular bone flap is the best surgical option in patients without significant comorbidities.

• Authors: Gabriele Molteni, Luca Gazzini, Andrea Sacchetto, Riccardo Nocini, Lara Valentina Comini, Valerio Arietti, Luca Giovanni Locatello, Giuditta Mannelli
• Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 280 Issue 9 Pg. 3953-3965 (Sep 2023) ISSN: 1434-4726 [Electronic] Germany
• PMID: 37269408 (Publication Type: Systematic Review, Journal Article, Review)
• Copyright: © 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• Titanium

Topics

• Humans
• Plastic Surgery Procedures
• Mandibular Reconstruction (methods)
• Titanium
• Surgical Flaps
• Head and Neck Neoplasms (surgery)
• Free Tissue Flaps
• Retrospective Studies