Reconstruction options in pediatric population with hemi or total mandibulectomy defects: A systematic review

Bansal, Adity; Nagori, Shakil Ahmed; Chug, Ashi; Dixit, Ashutosh; Chowdhry, Rebecca; Reddy, Srinivas Gosla

doi:10.1016/j.jobcr.2022.03.001

Cited by 4 publications

(9 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As normal maxillary growth is dependent on an intact dental arch, it is difficult to predict growth of the maxilla after hemi-maxillectomy. 1,5,13 In hemi-maxillectomy, during which half of the dental arch is removed, the transverse growth of the remaining dental arch, and thus the maxilla, is compromised. 5 These patients tend to develop a large lingual maxillary crossbite that is extremely hard to correct due to resultant postoperative scarring and soft tissue contracture.…”

Section: Discussionmentioning

confidence: 99%

“…However, larger mandibular defects require vascularized bone, which increases the likelihood of postoperative neomandibular growth, which is vital in pediatric patients. 9,13,15 The vascularized free fibula flap is a reliable method to reconstruct hemimandibular defects and portends minimal donor site complications. 11,[15][16][17][18][19][20] The fibular flap can be used to reconstruct the mandibular condyle in complete hemimandibulectomy patients, which preserves the mandibular height for optimal occlusion and restores the temporomandibular joint postoperatively.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric Maxilla-Mandible Oncoplastic Reconstruction: A 25 Patient Case Series

Burns,

Yim,

Hashemi

et al. 2023

FACE

View full text Add to dashboard Cite

Objective: We present a case series of 25 pediatric patients who underwent maxillary and mandibular oncoplastic reconstruction at a single institution. Further, we discussed the present review of the literature and underscored the unique considerations for the pediatric population. Methods: A retrospective chart review of 25 pediatric oncoplastic patients undergoing maxillary and/or mandibular reconstruction was performed from March 2015 to January 2022. Results: Thirteen patients underwent maxillary reconstruction, and 12 patients underwent mandibular reconstruction. The mean age of the maxillary cohort was 10.2 years, and the mean age of the mandibular cohort was 9.8 years. The age range of patients followed was from 6 months to 18.8 years. All patients displayed satisfactory postoperative swallowing and facial symmetry at subsequent follow-up visits. Conclusion: Maxillary and mandibular reconstruction following oncologic resection requires special attention in the pediatric population because of the difficulty to predict bony growth of the mid and lower face, and the resultant effects on dentition and symmetry. Our case series demonstrates successful pediatric maxillomandibular reconstruction utilizing microvascular free tissue transfer and 3D virtual surgical planning.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pediatric Maxilla-Mandible Oncoplastic Reconstruction: A 25 Patient Case Series

Burns,

Yim,

Hashemi

et al. 2023

FACE

View full text Add to dashboard Cite

show abstract

“…The maximal interincisal opening achieved at the last follow-up was 31.67 ± 7.93 mm, and all implants were functional. The application of alloplastic TJR in the construction of congenital mandibular deformities is rare, and only a few case reports have been published to date, mostly focused on non-growing patients [27][28][29][30][31]. The treatment of patients with alloplastic TJR in general, in adults, and in juvenile patients differs markedly across countries and healthcare systems.…”

Section: Discussionmentioning

confidence: 99%

“…Costochondral grafts have an inherent growth potential but are unpredictable [ 15 ]. Long-term reports of mandibular growth in children who underwent reconstruction with costochondral grafts showed that excessive growth occurred on the treated side in 54% [ 27 , 28 , 36 – 40 ]. An investigation of mandibular growth after costochondral grafting supported previous experiments regarding the inability of the graft to adapt to the growth velocity of the new environment.…”

Section: Discussionmentioning

confidence: 99%

Congenital Mandibular Hypoplasia: Patient-Specific Total Joint Replacement as a Line Extension in the Treatment of Complex Craniofacial Anomalies

Zimmerer

Sander

Schönfeld

et al. 2022

J. Maxillofac. Oral Surg.

View full text Add to dashboard Cite

Introduction Congenital mandibular hypoplasia (CMH) remains challenging because of the underlying combined hard and soft tissue deficiency. Treatment options include craniofacial distraction, orthognathic surgery, and autologous grafts, although the latter produces inadequate results after distraction and autologous grafting. Unsatisfactory long-term stability may cause relapse, necessitating reoperation. Material and Methods We investigated the feasibility of using alloplastic total joint replacement (TJR) in growing and young adult CMH patients. The primary outcome was long-term reconstruction stability, without implant failure. Secondary outcomes were TMJ function and pain, and jaw movements achieved during surgery. Results Three patients (age: 9–22 years) were treated by the same surgeon at one institution during 2018–2021. Anamnesis and clinical parameters were obtained from patient records. Preoperative 3D-scans were superimposed with postoperative 3D-scans and preoperative plans, including TJR-implant STL files, to measure jaw movement. All patients underwent prior reconstructive surgery. Mandibular movement of 16.4–20.1 mm in the sagittal direction was achieved. Post-TJR follow-up ranged from 24 to 42 months. No long-term complications occurred. At the latest follow-up, the maximal interincisal opening was between 21 and 40 mm, and all implants were functioning, without failure. Conclusion In selected CMH cases, alloplastic TJR can deliver satisfactory medium-term results with predictable and stable outcomes, even in growing patients.

show abstract

“…24 66 In pediatric patients, mandibular resection poses risks of asymmetrical facial growth, maxillary hypoplasia, and malocclusion. 67 68 Immediate reconstruction should focus on ensuring oral competence and mandibular symmetry.…”

Section: General Reconstructive Considerationsmentioning

confidence: 99%

Pediatric Craniofacial Tumor Reconstruction

Parham,

Ding,

Wang

et al. 2023

Semin Plast Surg

View full text Add to dashboard Cite

Effective management of pediatric craniofacial tumors requires coordinated input from medical, oncologic, and surgical specialties. Reconstructive algorithms must consider limitations in pediatric donor tissue and account for future growth and development. Immediate reconstruction is often focused on filling dead space, protecting underlying structures, and ensuring skeletal symmetry. Staged reconstruction occurs after the patient has reached skeletal maturity and is focused on restoring permanent dentition. Reconstructive options vary depending on the location, size, and composition of resected tissue. Virtual surgical planning (VSP) reduces the complexity of pediatric craniofacial reconstruction and ensures more predictable outcomes.

show abstract

Reconstruction options in pediatric population with hemi or total mandibulectomy defects: A systematic review

Cited by 4 publications

References 36 publications

Pediatric Maxilla-Mandible Oncoplastic Reconstruction: A 25 Patient Case Series

Pediatric Maxilla-Mandible Oncoplastic Reconstruction: A 25 Patient Case Series

Congenital Mandibular Hypoplasia: Patient-Specific Total Joint Replacement as a Line Extension in the Treatment of Complex Craniofacial Anomalies

Pediatric Craniofacial Tumor Reconstruction

Contact Info

Product

Resources

About