Anterior mandibular osteotomy for tumor extirpation: A critical evaluation

Background. Anterior mandibular osteotomy gives excellent access to the oro pharynx for oncologic resections. Although rigid internal fixation has impr oved results in stability and bone healing, side effects and complications of the surgical procedure must be considered. Methods. Between 1991 and 1997, 64 patients underwent a transmandibular app roach for benign or malignant tumors of the head and neck. Sixty-one of the m were included in a B-month follow-up study. Final results and major and m inor complications were recorded. Results. Three (5%) cases of non-union and infection of the osteotomy site required plate removal, curettage, and reosteo-synthesis. Occlusal disturba nces and local periodontal disease occurred in 2 (3%) patients. Thirty-two (52%) patients complained of sensitivity disturbances, 18 (30%) of temporom andibular joint pain, and 44 (72%) of a limitation in opening the mouth. Si x patients (10%) had a cosmetic complaint. Conclusion. Dental condition and periodontal care in the vicinity of the os teotomy are important factors in reducing the risk of major complications. Trismus, limitation of joint motion, and pain cannot be directly related to the technique; they depend on the extent of tumor resection and postoperat ive radiotherapy. (C) 2000 John Wiley & Sons, Inc.