Minimizing complications in the use of titanium condylar head reconstruction prostheses

Abstract

Objective The study goals were to evaluate the use of titanium condylar prostheses in the setting of tumor resection and to discuss the techniques used to minimize complications. Study design and setting We conducted a retrospective review of a case series in a tertiary care hospital. Six patients underwent mandibulectomy, including the condyle, with primary reconstruction using titanium condylar prostheses. Charts were reviewed for operative technique, pathology, and complications. Results Pathology included squamous cell carcinoma, Ewing's sarcoma, embryonic rhabdomyosarcoma, giant cell granuloma, and adenocarcinoma. Three patients are alive without disease. Follow-up spanned 6.4 years with premorbid occlusion established in all cases, and there were no prosthesis extrusions or erosions. The condylar head was wrapped in preserved joint capsule or adjacent temporalis muscle/fascia and secured with permanent purse-string sutures; careful duplication of the length, and angulation of the native mandible from the angle to the superior extent of the condylar head. Conclusion Titanium condylar prostheses are a viable choice in the setting of tumor resection and reconstruction, with appropriate technical precautions.