Changes of the facial soft tissue after mandibular reconstruction using vascularized iliac flap.

Abstract

To reveal the change patterns of the facial soft tissue after applying mandibular reconstruction. 16 Patients with mandibular benign tumor were recruited in this retrospective study. For all patients, segmental mandibular osteotomy and concurrent reconstruction using vascularized iliac flap were conducted. The soft tissue thickness of patients' lower face was measured with CT scans before surgery, 1week, 6months and 1year after surgery. The time-dependent changes of tissue thickness were analyzed. The most significant tissue swelling was 28.86%, at 1week after the surgery. The average increase of tissue thickness was 4.78 ± 5.30mm across patient. After 1year of the surgery, tissue thickness decreased to the level before operation or the level of the healthy side. The thickness of the low-density tissue fluctuated mildly, while the thickness of the high-density tissue fluctuated significantly. The disuse atrophy of the masseter occurred 1week after the surgery, and was reversed after 1year. The removal of the submandibular gland caused depression in submandibular area, which intensified over time. Across patients, soft tissue thickness in the lower face after mandibular osteotomy and reconstruction increased significantly 1week after the surgery, and decreased over time. After 1year, tissue thickness went back to the pre-surgery level, where matched up with the healthy side. We documented the change patterns of the facial soft tissue after mandibular reconstruction. These results can help improve the planning of virtual surgeries and the timing for aesthetic assessment. ClinicalTrials.gov Identifier: ChiCTR2100054103.