Resection and immediate reconstruction of parts of the mandible via intra-oral route.

Our experience in partial resection of parts of the mandible with immediate reconstruction using the iliac crest via the intraoral route is presented. 12 patients were treated in this way and the follow up varied between 1 to 3 years. The criteria assessed in the follow up included, behaviour of the bone graft, aesthetics functional behaviour of the bone transplant under the denture plates, and function of the mandibular branch of the facial nerve. Though infection with discharge of pus was noticed a few days post-operatively, with meticulous care with the use of systemic antibiotics and local irrigation of the wounds with antibiotics solution, the infection was usually overcome. Only in 2 cases were the bone grafts removed because the patients could not tolerate the nasogastric tube feeding for more than 2 or 3 days post-operatively and there was wound dehiscence with exposure of the graft. However the result achieved in this study made us conclude that the intra-oral approach for resection and immediate reconstruction of parts of the mandible will be our method of choice whenever possible.