Labiomental sensation after segmental mandibulectomy and inferior alveolar nerve preservation for osteoradionecrosis

Drouet, J.C.; Garmi, Rachid; Ambroise, Bruno; Chatellier, Anne; Veyssière, A.; Hervé, Bénateau

doi:10.1016/j.jormas.2020.10.004

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…The post-surgical sequelae of mandibular resection are relevant because they severely affect the quality of life of patients ( 10 ). Preservation of the IAN in maxillofacial surgical procedures where surgical resection of the mandibular bone has been performed is an alternative that has shown successful outcomes in terms of a reduction in postoperative sequelae ( 4 , 10 , 13 ), and is currently positioned as a necessary and feasible procedure ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

Preservation of the inferior alveolar vasculonervous bundle in mandibular resective therapies: systematic review and report of two cases

Tapia,

Matus-Miranda,

Díaz

et al. 2024

Med Oral

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Background Segmental surgical resection is a frequently indicated procedure to treat aggressive mandibular tumors. One of the most important complications derived from this technique is permanent paresthesia of the inferior alveolar nerve (IAN), which significantly affects the quality of life of patients who experience it. This could be avoided through maneuvers that preserve the IAN. The objective of this paper is to review the main techniques for IAN preservation and to present 2 cases with the technique used by the author. Material and Methods A systematic review was performed according to the PRISMA guidelines, apropos of two clinical cases reported in this study. The MEDLINE/PubMed and Scopus databases were searched. Several variables were considered and are presented in detail in the form of Tables and Figures. In addition, 2 case reports with NAI preservation techniques are presented. Results 13 articles were finally obtained for analysis. 127 patients were evaluated, reporting mandibular resections associated with various pathologies. Various surgical techniques were used, all with the same goal of maintaining the IAN. In most of the patients, the maintenance of sensitivity was achieved, which was verified with different methods. Conclusions Preservation of the IAN in maxillofacial surgical procedures where surgical resection of the mandibular bone has been performed is an alternative that has demonstrated successful results in terms of reducing postoperative sequelae and is currently positioned as a necessary and feasible procedure. Key words: Mandibular nerve, mandible, maxillofacial injuries, oral pathology, oral surgery.

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Section: Discussionmentioning

confidence: 99%

Preservation of the inferior alveolar vasculonervous bundle in mandibular resective therapies: systematic review and report of two cases

Tapia,

Matus-Miranda,

Díaz

et al. 2024

Med Oral

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“…20 Several attempts have long been reported to preserve IAN while performing mandibulectomy; however, such approach is limited to benign lesions, where clear margins can be achieved, meanwhile preserving IAN. [21][22][23][24][25][26][27][28] Unfortunately, this is not appropriate for malignant tumors or aggressive benign lesions that necessitate sacrifice of IAN for tumor free margins. Moreover, some scholars do not recommend IAN preservation as being conservative and sparing IAN in some tumors is detrimental.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the great improvements of various techniques of mandible reconstruction following oncologic resection; however, still there would be little consideration to repair IAN and preserve lower lip sensations 20 . Several attempts have long been reported to preserve IAN while performing mandibulectomy; however, such approach is limited to benign lesions, where clear margins can be achieved, meanwhile preserving IAN 21–28 . Unfortunately, this is not appropriate for malignant tumors or aggressive benign lesions that necessitate sacrifice of IAN for tumor free margins.…”

Section: Discussionmentioning

confidence: 99%

Novel loop neurorrhaphy technique to preserve lower lip sensate in mandibular reconstruction using an innervated vascularized iliac bone flap

et al. 2021

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Background: This study aimed to introduce a novel loop neurorrhaphy technique using an innervated vascularized iliac bone flap (VIBF) with vascularized ilioinguinal nerve (IIN) to reconstruct the inferior alveolar nerve (IAN) and preserve lower lip sensation simultaneously with mandibular reconstruction.Methods: This study prospectively included patients who underwent mandibular reconstruction using VIBF from May 2018 to April 2020. Subjects were allocated into two groups: (1) Group I; innervated VIBF with loop neurorrhaphy (IIN doubly anastomosed with IAN and mental nerve), (2) Group II (control); conventional VIBF. Evaluation was done with operative time, intraoperative indocyanine green (ICG), lower lip sensory assessment (twopoint discrimination [TPD] test and current perception threshold [CPT]), and drooling.Results: Twelve patients were included; 6 in each group, (7 males and 5 females), age ranging from 18 to 57 years (average: 36.75 years). In all cases, intraoperative perfusion of IIN was confirmed by ICG. Group I showed a statistically significant more flap harvesting time compared with group II (mean difference, 5.67 min; P = 0.0091). There was a significant difference in sensory recovery favoring group I (P < 0.05). The TPD results in group I showed an average of 9.8 ± 6.9 mm and 6.2 ± 5.7 mm on operated and non-operated sides, while Group II showed a poor sensory recovery, and the TPD showed an Ahmed Abdelrehem and Jingcun Shi share the work as first co-authors.

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“…segmental dapat menurunkan kualitas hidup pasien yang disebabkan oleh asimetri wajah, serta kelainan pada mandibula yang dapat menyebabkan disfungsi pada pengunyahan dan artikulasi. 11,24,25,26 Upaya meminimalkan efek terapi, rekonstruksi perlu dilakukan untuk menjaga kualitas hidup pasien. 9,10,11 .…”

Section: Mandibulektomiunclassified

“…Cangkok autogenous dapat digunakan sebagai cangkok tulang non-vaskularisasi atau vaskularisasi untuk kontinuitas mekanis dan efisiensi defek tulang yang dihasilkan dari reseksi tumor. Fibula merupakan pilihan terbaik karena karakteristik tulang yang panjang dan berbentuk tabung dengan kekuatan yang baik untuk menjaga kelangsungan gaya lengkung rahang dan pengunyahan 16,24,25,26 Fibula juga dianggap sebagai cangkok tulang autogenous terkuat yang tersedia jika dibandingkan dengan situs donor autograft kortikal lainnya seperti krista iliaka dan poros tibialis anterior. 11,27,28 Cangkok tulang non-vaskularisasi memiliki kelebihan antara lain waktu operasi dan periode rawat inap yang dapat dipersingkat dibandingkan dengan flap tulang vaskularisasi.…”

Section: Mandibulektomiunclassified

<p>Mandibulektomi segmental dengan rekonstruksi cangkok tulang fibula non-vaskularisasi pada pasien ameloblastoma tipe folikuler</p><p>Segmental mandibulectomy with non-vascularised fibular bone graft reconstruction in follicular ameloblastoma patient</p>

2021

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Pendahuluan: Ameloblastoma adalah tumor invasif lokal dengan insidensi kekambuhan yang tinggi jika tidak dieksisi sepenuhnya. Mandibulektomi segmental sebagai pilihan tatalaksana yang dapat menyebabkan deformitas dan asimetri pada wajah, serta masalah pengunyahan. Pemulihan defek setelah reseksi mandibula menimbulkan masalah yang cukup berat. Tujuan laporan kasus ini untuk melaporkan hasil rekontruksi menggunakan cangkok tulang non-vaskularisasi mandibulektomi segmental pada pasien dengan ameloblastoma mandibula. Laporan kasus: Pria berusia 33 tahun datang ke Poliklinik Rawat Jalan Bagian Bedah Mulut dan Maksilofasial RS Persahabatan dengan keluhan utama pembengkakan mandibula yang perlahan bertambah dan tidak nyeri sejak enam tahun lalu. Pemeriksaan ekstra oral tampak asimetri wajah, bukaan mulut tidak ada limitasi, tidak teraba pembesaran kelenjar getah bening regio leher. Pemeriksaan intraoral didapatkan adanya benjolan regio mandibula kiri dengan batas tegas, konsistensi padat, permukaan tampak trauma oklusi gigi antagonis, immobile, dan terdapat nyeri tekan. Gambaran radiologis menunjukan lesi radiolusen multilokuler menyerupai honeycomb pada corpus mandibula kiri meluas ke regio ramus mandibula kiri. Pemeriksaan biopsi menunjukkan hasil ameloblastoma tipe folikuler pada mandibula kiri dan dilakukan mandibulektomi segmental dengan rekonstruksi cangkok tulang fibula non-vaskularisasi. Sembilan bulan setelah operasi, cangkok tulang non-vaskularisasi tidak menunjukkan komplikasi intraoral dengan bekas luka submandibular ekstraoral baik. Simpulan: Cangkok tulang fibula non-vaskular dapat dipertimbangkan sebagai salah satu pilihan untuk rekonstruksi setelah mandibulektomi segmental pada pasien ameloblastoma.Kata kunci: Mandibulektomi segmental, cangkok fibula non-vaskularisasi, ameloblastoma folikuler. ABSTRACTIntroduction: Ameloblastoma is a locally invasive tumour with a high incidence of recurrence if not completely excised. Segmental mandibulectomy as a treatment option that can cause facial deformities and asymmetry and mastication problem. Recovery of the defect after mandibular resection presents a severe problem. This case report was aimed to report the results of reconstruction using a segmental non-vascularised mandibulectomy bone graft in a patient with mandibular ameloblastoma. Case report: A 33-year-old male came to the Outpatient Polyclinic of the Oral and Maxillofacial Surgery Division of Persahabatan General Hospital with the chief complaint of mandibular inflammation, which was slowly increasing yet painless since six years prior. Extraoral examination showed facial asymmetry, no limitation in mouth opening, no palpable enlargement of lymph nodes in the neck region. Intraoral examination revealed a lump in the left mandibular region with firm borders, solid consistency. The surface appears to be traumatic occlusion of the antagonist tooth, immobile, and tenderness was found. Radiological features showed a multilocular, honeycomb-like radiolucent lesion on the left mandibular body extending into the left mandibular ramus region. A biopsy showed follicular ameloblastoma in the left mandible, and a segmental mandibulectomy was performed with non-vascular fibular bone graft reconstruction. Nine months after surgery, non-vascular bone grafts showed no intraoral complications with either extraoral submandibular scar. Conclusion: Non-vascular fibular bone graft can be considered an option for reconstruction after segmental mandibulectomy in ameloblastoma patients. Keywords: Segmental mandibulectomy, non-vascularised fibula graft, follicular ameloblastoma.

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Labiomental sensation after segmental mandibulectomy and inferior alveolar nerve preservation for osteoradionecrosis

Cited by 5 publications

References 12 publications

Preservation of the inferior alveolar vasculonervous bundle in mandibular resective therapies: systematic review and report of two cases

Preservation of the inferior alveolar vasculonervous bundle in mandibular resective therapies: systematic review and report of two cases

Novel loop neurorrhaphy technique to preserve lower lip sensate in mandibular reconstruction using an innervated vascularized iliac bone flap

<p>Mandibulektomi segmental dengan rekonstruksi cangkok tulang fibula non-vaskularisasi pada pasien ameloblastoma tipe folikuler</p><p>Segmental mandibulectomy with non-vascularised fibular bone graft reconstruction in follicular ameloblastoma patient</p>

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