Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
Yonsei Med J. 2013 Sep;54(5):1248-52. doi: 10.3349/ymj.2013.54.5.1248.
To review the 5-year outcomes of our modified mandibulotomy technique. Retrospective review of a tertiary level oral cancer center.
During a 5-year period, 30 patients who had a uniform surgical technique consisting of a lower lip-splitting, modified stair-step osteotomy with thin saw blade and osteotome after plate-precontouring and combination fixation with monocortical osteosynthesis (miniplate) and bicortical osteosynthesis (maxiplate and bicortical screws), with at least 14 months postoperative follow-up, were selected and reviewed retrospectively.
There were 8 women and 22 men with an average age of 56.5 years. All the patients involved malignancies were squamous cell carcinoma. The main primary sites of the those who underwent a mandibulotomy were the tonsil, the base of tongue, the oral tongue, the retromolar pad area, and others. Others included buccal cheek, floor of mouth, and soft palate. 23 patients received postoperative radiation therapy, and among whom 8 patients also received chemotherapy. Total four (13%) mandibulotomy-related complications occurred, only two (6.7%) requiring additional operation under general anesthesia.
Our modified mandibulotomy meets the criteria for an ideal mandibulotomy technique relatively well because it requires no intermaxillary fixation, can precise preserve the occlusion in a precise way, allows early function, requires no secondary procedures, and has few complications.
回顾我们改良下颌骨切开术的 5 年结果。对三级口腔癌中心的回顾性研究。
在 5 年期间，选择了 30 名患者，他们采用了统一的手术技术，包括下唇切开、改良梯级式截骨术，使用薄锯片和骨凿，在预塑形钢板后进行，并采用单皮质骨合成（微型板）和双皮质骨合成（大钢板和双皮质螺钉）进行组合固定，至少有 14 个月的术后随访。
有 8 名女性和 22 名男性，平均年龄为 56.5 岁。所有涉及的患者均为恶性肿瘤，均为鳞状细胞癌。接受下颌骨切开术的主要原发部位为扁桃体、舌根、口腔舌、磨牙后垫区和其他部位。其他部位包括颊部、口底和软腭。23 例患者接受了术后放疗，其中 8 例患者还接受了化疗。共发生 4 例（13%）下颌骨切开术相关并发症，仅 2 例（6.7%）需要在全身麻醉下进行额外手术。
我们的改良下颌骨切开术相对较好地符合理想下颌骨切开术技术的标准，因为它不需要颌间固定，可以精确地以精确的方式保留咬合，允许早期功能，不需要二次手术，并且并发症较少。
