Prevention of collapse of the contralateral half of the mandible after hemimandibulectomy: Our experience in a low-resource center

Abstract

Background: The management of pathologic lesions of the mandible includes plans for the reconstruction of the resultant defect to give the patients optimal surgical reconstructive and prosthetic results. Objective: To evaluate the degree of deviation of the contralateral half of the mandible toward the surgical defect after hemimandibulectomy and intermaxillary fixation (IMF). Patients and Methods: This is a 9-year prospective single-blinded clinical study conducted at the Dental and Maxillofacial Surgery Clinic of our institution. Information obtained from the patients included age, gender, type of mandibular lesion, method of wound closure, duration of IMF, temporo-mandibular joint (TMJ) symptom(s), and the deviation toward the surgical defect of the remnant contralateral half of the mandible, measured in centimeter at maximum mouth opening. Results: Ninety-six patients, unevenly distributed according to their duration of tolerance of IMF, were studied. The age of the patients ranged from 29 to 57 years with an overall mean age of 42.6 ± 5.1 years. There were 72 males and 24 females with a male-to-female ratio of 3:1 (P = 0.001). The lesions that were extirpated were all benign, and ameloblastoma was the most common tumor (P = 0.001). The shorter the duration of IMF, the greater the deviation of the mandibular mid-line toward the surgical defect (P = 0.001). Conclusion: This study shows that there is a deviation of mid-line of the residual mandible toward the surgical defect after hemimandibulectomy, even after its immobilization with IMF for 4–12 weeks. IMF is still useful in the prevention of mandibular collapse after hemimandibulectomy.