Mandibular Access Osteotomy for Tumor Ablation: Could a More Tissue-Preserving Technique Affect Healing Outcome?

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Mandibular Access Osteotomy for Tumor Ablation: Could a More Tissue-Preserving Technique Affect Healing Outcome?

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dc.contributor.author Bengtsson, Martin
dc.contributor.author Korduner, Mikael
dc.contributor.author Cambell, Vanessa
dc.contributor.author Fransson, Philip
dc.contributor.author Becktor, Jonas
dc.date.accessioned 2016-12-15T11:49:23Z
dc.date.available 2016-12-15T11:49:23Z
dc.date.issued 2016 en_US
dc.identifier.citation 2085-2092 en_US
dc.identifier.issn 0278-2391 en_US
dc.identifier.uri http://hdl.handle.net/2043/21691
dc.description.abstract Purpose: Paramedial mandibulotomy facilitates access for the resection of tumors in the oral and oropharyngeal space; however, severe complications related to surgical techniques and radiotherapy have been reported for this procedure. This study evaluated whether preservation of the periosteum during a mandibulotomy would decrease postoperative complications owing to the increased healing capacity provided by preserving more tissue. Materials and Methods: Patients who underwent mandibulotomy for surgical tumor ablation from 2007 through 2012 were included in a retrospective controlled cohort study. The trial was comprised of 2 groups: 1 group underwent subperiosteal and 1 group underwent supraperiosteal surgical dissection in the area of the mandibulotomy. The primary predictor variable was surgical technique and the primary outcome variable was surgical complications. The groups were matched according to tumor type, age, and gender. Clinical and radiographic follow-up was performed 12 months after surgery. Complications regarding bone exposure, plate exposure, osteoradionecrosis, nonunion, infection of the soft tissue flap, abscesses, fistulas, and gingival necrosis were recorded. Recordings of other factors, such as age, smoking habits, and timing of radiotherapy and chemotherapy, were performed and the 2 groups were compared for postoperative complications. Data analysis used the c2 test (Fisher exact test) to compare the sub- and supraperiosteal groups for postoperative complications. Results: Thirty-two patients were included (16 per group; 14 women and 18 men; mean age, 56 yr). Thir- teen patients in the subperiosteal group and 7 in the supraperiosteal group showed complications during the first 12 months. Seven patients had complications that persisted to the 12-month follow-up (6 in the subperiosteal group and 1 in the supraperiosteal group); however, the difference was not statistically relevant. Conclusion: This study found more persistent complications in the subperiosteal group compared with the supraperiosteal group at 12-month follow-up, which could imply that a more tissue-preserving surgical technique promotes mandibular healing in patients undergoing mandibular access osteotomy in combination with radiotherapy. en_US
dc.language.iso eng en_US
dc.publisher Elsevier en_US
dc.subject.classification Medicine en_US
dc.title Mandibular Access Osteotomy for Tumor Ablation: Could a More Tissue-Preserving Technique Affect Healing Outcome? en_US
dc.type Article, peer reviewed scientific en_US
dc.contributor.department Malmö University. Faculty of Odontology
dc.identifier.doi 10.1016/j.joms.2016.03.036 en_US
dc.subject.srsc Research Subject Categories::ODONTOLOGY en_US
dc.relation.ispartofpublication Journal Oral Maxillofac Surgery;10
dc.relation.ispartofpublicationvolume 74 en_US
dc.description.authorversion No en_US
dc.identifier.pmid 27131029
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