Lag screw fixation for straight midline mandibulotomy: four-year experience.

The authors' experience with 2-lag screw technique for the stabilization of a straight midline mandibulotomy approach for oral cavity and oropharyngeal tumors is presented. Fixation is performed with 2.0-mm pretapped screws. A washer is used to prevent sinking of the screw head into spongy bone and to provide equal pressure distribution of the screw head to the bone edges. Lag screw fixation was used in 24 patients, 18 of whom underwent a full dose of irradiation therapy postoperatively. Two patients developed salivary fistula and 1 developed a local infection. In all patients there were no signs of mandibulotomy site instability, no disturbance of the occlusion, and radiography showed excellent bone healing. There were no indications for tooth extraction to complete the osteotomy. Lag screw fixation proved to be an uneventful and straightforward procedure for the stabilization of a straight midline mandibulotomy approach.