Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria.
Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria.
Int J Oral Maxillofac Surg. 2019 Apr;48(4):468-474. doi: 10.1016/j.ijom.2018.11.007. Epub 2018 Dec 5.
The purpose of this study was to describe a newly developed procedure for temporary mandibulotomy and subsequent osteosynthesis. Clinical outcomes were evaluated, including complications and the impact on postoperative treatment, particularly postoperative radiotherapy. Twenty-four patients underwent temporary mandibulotomies for the surgical resection of malignancies located in the posterior oral or oropharyngeal region. All were treated with postoperative radiotherapy. An angulated median mandibulotomy was followed by osteosynthesis with three anchor screws directed towards the inferior aspect of the mandible. Anchor screws are modified conventional lag screws that include an additional biconcave washer. This modification prevents the screw heads from cracking into the cancellous bone during tightening, improving their biomechanical qualities considerably. Insertion of screws at any angle to the bony surface therefore becomes possible, which is a precondition for this technique. Minor complications occurred in two patients in the early postoperative period. However, complications causing bony non-union, leading to postponed postoperative radiotherapy were not noted in this cohort.
本研究旨在描述一种新开发的暂时性下颌切开术及随后的骨合成术。评估了临床结果，包括并发症以及对术后治疗的影响，特别是术后放疗。24 例患者因口腔后部或口咽部恶性肿瘤接受暂时性下颌切开术。所有患者均接受术后放疗。采用斜行正中下颌切开术，然后用 3 个锚定螺钉向下颌骨下方方向进行骨合成。锚定螺钉是改良的常规拉力螺钉，其中包括一个附加的双凹垫圈。这种改良可防止螺钉头在拧紧过程中裂入松质骨，从而大大提高其生物力学性能。因此，螺钉可以以任何角度插入到骨表面，这是该技术的前提条件。两名患者在早期术后出现轻微并发症。然而，在本队列中未发现导致骨不愈合，从而导致推迟术后放疗的并发症。
