State-of-the-art mandible reconstruction using revascularized free-tissue transfer

Abstract

Mandible defects are created by trauma as well as ablative surgery for both benign and malignant tumors. Ablative surgery for malignant tumors creates complex defects that impact form and function. This is often further complicated by the use of chemotherapy and radiation. In order to achieve a highly functional reconstruction with an acceptable cosmetic result, patients must be properly evaluated preoperatively. A patient’s performance status and expectations for postoperative form and function can impact reconstruction. Once the defect is created, both the bone and soft-tissue loss must be considered. A structured approach to mandible defects will enable the re-establishment of mandible continuity and optimal soft-tissue reconstruction. This will ultimately lead to a patient with oral competence and limited swallowing deficits, as well as the ability to communicate effectively and interact with their community in a meaningful manner. There are ongoing investigations into new techniques and materials, such as distraction osteogenesis and tissue engineering, which will hopefully advance our ability to reconstruct the mandible.