Reconstruction of mandible after excision of primary malignant tumors

ABSTRACT

Seventeen patients with primary malignant tumor of mandible adamantionoma were treated with surgical excision of the tumor with safety margin. Wedge resection was done in small sized tumors, while hemimandibulectomy was achieved in large sized tumors affecting ramus or encroaching on temporomandibular joint. Immediate mandibular reconstruction was achieved in 9 patients using rib grafts and meshed trays or synthetic plates according to the defect. Eight patients underwent delayed reconstruction after 3-6 months of primary tumor excision using rib-bone grafts and meshed trays. Four patients out of 9 patients, who underwent immediate primary reconstruction of mandible, developed wound infection and rib graft was absorbed in 3 of them and plate graft was rejected in one of them. All patients who underwent delayed repair of mandible got excellent results. The cosmetic results were excellent [55% of primary repair and 88% in secondary repair]