Improved mandible function after hemimandibulectomy, condylar head preservation, and vascularized fibular reconstruction

Temporomandibular joint dysfunction after tumor extirpation of the hemimand ible is a frequent sequela after condylar head reconstruction. Condylar hea d resection is often performed because of oncological and vascular consider ations. Recent studies have demonstrated that malignancies of the mandibula r ramus and body rarely involve the condylar head, and that the vascularity and supportive structures of the condylar head are sufficient to maintain viability and function. This study demonstrates that temporomandibular join t function is preserved after hemimandibulectomy without resection of the c ondylar head, Fixation of a vascularized fibular flap to the condylar head is performed in situ, Condylar viability and growth is maintained with pain less incisal opening. The condylar head is a growth center for the mandible in the pediatric population. Its preservation in these patients will avoid the long-term problems associated with growth center loss such as malocclu sion and concomitant maxillary deformity.