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At least 19 recordsLinked to original sources
PubMed1985

Delayed mandibular reconstruction following removal of a mesenchymal chondrosarcoma. Report of a case.

An unusual case of mesenchymal chondrosarcoma is presented. Initially seen when the patient was 8 years old, the lesion was repeatedly biopsied and curetted with a diagnosis of odontogenic fibroma. In 1971 a diagnosis of osteosarcoma of the chondroblastic type was made. At that time, the patient underwent a partial mandibulectomy with immediate graft. The patient did well until 1981, when a recurrence of the lesion was noted. The microscopic diagnosis at this time was mesenchymal chondrosarcoma. The treatment of this lesion as a staged procedure with initial resection of the mandible and placement of a silicone rubber mandibular prosthesis is discussed. The second stage of the procedure was definitive mandibular reconstruction, with an allogeneic mandible as a crib for autologous particulate cancellous bone from the iliac crest. Although the prognosis of mesenchymal chondrosarcoma is usually grave, this case is unusual because of its long history of multiple procedures performed prior to the definitive treatment of the lesion 14 years after its discovery. Two-year follow-up since the definitive mandibular reconstruction shows adequate range of motion, excellent healing, and no recurrence.

Bone Transplantation↗
PubMed1977

Titanium implants as a temporary replacement of mandible. A report of 30 cases.

In a 5-year period, 30 titanium implants (Bowerman and Conroy 1969) were utilised for the reconstruction of mandibular defects following tumour operations. Of these, 20 implants were removed prematurely. Reasons for early removal were: 1. postoperative dehiscence of wound (5), 2. perforation through the skin or mucosa (5), 3. infection of graft bed (7), 4. breakage of the implant (1), 5. tumour recurrence (2). A total of 9 implants were retained for one or more years. The results are compared with those of Bowerman (1974). Reasons for the early loss as well as the clinical implications are discussed.

Biocompatible Materials↗
PubMed1978

[Therapeutic principles in angioma of the mandible: applications in relation to a clinical observation (author's transl)].

When confronted with a case of angioma of the mandible, treatment should be directed towards two main areas:--to stop blood loss. Ligature of the external carotid can be life-saving, but it does not prevent the formation of nearby anastomotic vessels which refill, more or less rapidly, the external carotid axis. Ligature make embolization impossible by femoral way. A by-pass operation to improve permeability is also dangerous if not impossible. Ligature should be reserved only for those cases in which there is an immediate threat to life. On the contrary, embolization is necessary before surgery. --to treat the angioma. As radiotherapy is not effective or is dangerous, surgical treatment is necessary; either by a conservative operation or by radical resection. All these facts are illustrated dramatically by the case reported.

Adult↗
PubMed1990

[Anatomo-functional consequences of the radical surgery of the cervico-cephalic region in oncologic patients].

The role of surgery in head and neck cancer treatment is now well established, as it appears the most effective approach to such patients, while other therapies (i.e. chemotherapy, radiotherapy) can be of some help as second choice procedures. Surgery demonstrates however its own pitfalls, as it can often cause secondary anatomo-functional defects. The main problems appear to be related to the impossibility of physiological feeding following composite resection for oral cancer. An immediate reconstruction by transposition of myocutaneous flaps is of the utmost importance, as it reestablishes the preoperative condition lessening hospitalization time and postoperative disabilities. Neurological lesions, an unfrequent major complication of cervical lymphadenectomy, can cover a wide range of seriousness, from hardly detectable sensorial deficits to the impossibility of spontaneous ventilation. In this paper the Authors, on the basis of their experience, describe the measures to be taken in order to avoid secondary lesions (or to minimize their effects) in head and neck cancer surgery.

Humans↗
PubMed1990

Major mandibular reconstruction with vascularized bone graft.

Mandibular reconstruction is one of the most challenging fields in plastic and reconstructive surgery. Deficiencies of the mandible occur in congenital anomalies, trauma, oral and mandibular neoplasms and osteoradionecrosis. Conventional reconstructive aids like bone grafting or insertion of a metallic implant often fail in such situations due to poor local blood supply, deficient oral lining, inadequate skin coverage, large mandibular defects, irradiated fields or infected wounds. A free vascularized bone graft of a osteocutaneous flap overcomes the incompetence of conventional mandible reconstruction. It offers not only a desirable length of vascularized bone, but also has an adequate skin lining for oral mucosa and external tissue deficiencies, as well as a "sandwich reconstruction" for the mandible. The results are usually satisfactory in terms of function and aesthetics. Experience in 8 cases with iliac and scapular osteocutaneous free flaps are presented and discussed in this report. We conclude that a vascularized bone graft, especially the iliac crest, provides reliable and contented results for major mandibular reconstruction.

Adult↗
PubMed1989

Primary placement of osseointegrated implants in microvascular mandibular reconstruction.

The goal of mandibular reconstruction is to rehabilitate the patient by restoring occlusal relationships, lower facial contour, oral continence, and a denture-bearing surface. One of the major advantages of the use of vascularized bone over all other methods of mandibular reconstruction is its ability to achieve dental rehabilitation rapidly. The use of osseointegrated dental implants is a valuable adjunct in oral rehabilitation. It provides the most rigid form of stabilization to withstand the forces of mastication. In situations in which soft tissue reconstruction or the height of the alveolar ridge is not sufficient for a tissue-borne denture, implants offer the most suitable alternative. Mandibular reconstruction with free tissue transfer techniques is ideally suited for the placement of implants. These can be inserted at the time of mandibular reconstruction. Four months after surgery, when the integration process has occurred, the implants are unroofed, loaded, and ready for prosthetic placement. We will present several representative patients who underwent mandibular reconstruction with microvascular free bone transfer who have been successfully rehabilitated by osseointegrated implants. The process of osseointegration, different types of dental implants, and issues regarding radiation and implants are discussed. This is the first report of dental rehabilitation by primary placement of dental implants in patients undergoing microvascular mandibular reconstruction.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1987

[Reconstruction following anterior sulco-mandibulectomy. The advantages and disadvantages of different procedures. Apropos of 85 cases].

A retrospective study was conducted on 85 case-reports of patients with epithelioma of anterior and anterolateral region of floor of mouth operated upon in the Stomatology and Maxillofacial Surgery Clinic of Salpêtrière hospital, Paris. An update review of recent advances in surgery for reconstruction of floor of mouth is completed by results of study of the case-reports showing evolution of ideas related to functional results and to vital prognosis (as function of tumoral stage).

Adult↗
PubMed1976

Reconstruction after mandibulectomy for cancer.

Reconstruction after mandbulectomy for cancer presents a major problem in head and neck surgery. This study reports the experiences with a planned staged method of reconstruction that aims at both cosmetic and functional rehabilitation and that is based on a close cooperation between surgeon and prosthodontist. Stabilization of the remaining mandibular fragments by means of intermaxillary fixation at the time the tumor is resected, delayed bone grafting, and preprosthetic surgery to allow the use of a functional denture are the high points of the method. The results in 58 patients are discussed.

Alveoloplasty↗
PubMed1986

Dacron mesh tray and cancellous bone in reconstruction of mandibular defects.

We used a Dacron-urethane mesh tray filled with cancellous bone for mandibular reconstruction in 17 patients. Five patients with traumatic defects and two with benign tumors developed solid, functional mandibles. Among ten patients with squamous cell carcinoma, eight had successful reconstruction; one required a second procedure. Mandibles of two of three patients with osteoradionecrosis were successfully reconstructed, but only one of three primary reconstructions was initially successful. The Dacron-urethane mesh tray has the advantage of being stiff but malleable. It easily fits the defect, is radiolucent, and may be used either before or after radiotherapy. We recommend delayed reconstruction, adequate soft-tissue coverage, good immobilization of the mandible, no intraoral contamination, especially with osteoradionecrosis, and hyperbaric oxygen in patients who have been irradiated or have osteoradionecrosis.

Adult↗
PubMed1988

Use of the Kirschner wire for mandibular reconstruction.

An adaptation of the Kirschner wire, using tie wires for fixation of the Kirschner wire in primary mandibular reconstruction following ablative surgery, is described. Eighteen patients with a Kirschner wire serving as a prosthesis following mandibular resection were followed up. Except for three patients, who had extensive resection of the tongue, all patients were judged as having satisfactory mastication and deglutition. Only two patients required another operation for wire-related complications. The Kirschner wire, when modified as presented, proved a dependable and stable prosthesis for mandibular reconstruction.

Adult↗