Mandibular reconstruction in the surgical management of head and neck tumors

Abstract

Tumor invasion of the mandible presents a virtual mandate for resection of the involved bone. These patients confront the head and neck surgeon with a taxing problem which requires careful assessment of the individual case and the selection of a reconstructive method from a host of options. Removal of the mandible increases the complexity of reconstruction, not only from the standpoint of cosmetic restitution but, in addition, and more importantly, restoration of the essential functions of mastication, alimentation, and articulation. The T-4 oral cavity lesions addressed here are entwined in a complex web of problems. Almost predictably, abuses of smoking and alcohol contribute to the medical and social disturbance. Frequently there is a poor social situation, such as a fragmented home, unemployment, or an absent support group. Suboptimal medical status is to be inspected, along with poor dental hygiene. Other major medical disorders frequently associated with oral cavity cancer include peripheral vascular disease, renal and hepatic disease, in addition to general inanition and malnutrition.