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Contributing factors to mandibulotomy complications: A retrospective study

 Woong Nam  ;  Hyung-Jun Kim  ;  Eun-Chang Choi  ;  Moon-Key Kim  ;  Eui-Wung Lee  ;  In-Ho Cha 
 Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, Vol.101(3) : 65-70, 2006 
Journal Title
 Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology 
Issue Date
Adult ; Aged ; Bone Plates/adverse effects ; Carcinoma, Squamous Cell/drug therapy ; Carcinoma, Squamous Cell/radiotherapy ; Carcinoma, Squamous Cell/surgery* ; Chemotherapy, Adjuvant/adverse effects ; Female ; Humans ; Intraoperative Complications* ; Jaw Fixation Techniques/adverse effects ; Logistic Models ; Male ; Mandible/surgery* ; Middle Aged ; Mouth Neoplasms/drug therapy ; Mouth Neoplasms/radiotherapy ; Mouth Neoplasms/surgery* ; Oral Surgical Procedures*/adverse effects ; Postoperative Complications* ; Radiotherapy, Adjuvant/adverse effects ; Retrospective Studies ; Risk Factors
OBJECTIVE: The purpose of this article is to investigate the complications associated with mandibulotomies and analyze contributing factors. STUDY DESIGN: A total of 103 patients, who had undergone a mandibulotomy for tumors of the oral cavity or oropharynx, were identified and their hospital records, clinical charts, and radiographs retrospectively reviewed. Variables associated with mandibulotomy complications (osteotomy type, osteotomy site, tooth extraction, fixation method, radiation, and chemotherapy) were classified and statistically analyzed. RESULTS: Various complications were encountered in 19 (18.4%) patients, and were classified into 2 categories: intraoperative and postoperative complications. Paramedian (42.7%) stair-step (86.4%) osteotomies had been frequently used. Rigid fixation using one monocortical plate, one bicortical plate, and screws (MCP + BCP [46.6%]) was the main fixation method and showed statistical significance in the complications of mandibulotomy (P < .05). Five (71.4%) out of 7 patients who received preoperative radiotherapy developed postoperative complications, and 3 (60%) out of 5 patients who received preoperative chemotherapy developed complications. Among the complications, nonunion was observed in 7 (6.7%) patients and osteoradionecrosis in 5 (4.9%). CONCLUSION: Paramedian stair-step osteotomy is recommended and the reapproximation is improved with minimal bone loss using a thin saw blade. Rigid monocortical and bicortical plate fixation (MCP + BCP) is advantageous to preventing postoperative complications. Perioperative radiation therapy contributes to those complications, therefore it is necessary to establish the precise position of the portals and the adequate dose of radiotherapy through consultation with a radiation oncologist preoperatively, and consider a proper surgical approach. Because infection is an important contributing factor, it is necessary to actively control the infection to decrease the incidence of complications.
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2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyung Jun(김형준) ORCID logo https://orcid.org/0000-0001-8247-4004
Nam, Woong(남웅) ORCID logo https://orcid.org/0000-0003-0146-3624
Cha, In Ho(차인호) ORCID logo https://orcid.org/0000-0001-8259-2190
Choi, Eun Chang(최은창)
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