Mandibulectomy

Mandibulectomy is a surgical procedure that involves the removal of a portion or the entirety of the mandible or lower jaw. This procedure is typically performed to treat oral cancer, benign tumors, or severe trauma to the jaw.

Indications

Mandibulectomy is primarily indicated for the treatment of oral cancer, particularly when the tumor has invaded the mandible. Other indications include the management of benign tumors such as ameloblastoma, osteosarcoma, and fibrosarcoma. In some cases, mandibulectomy may also be performed to manage severe trauma to the jaw that cannot be repaired with other surgical techniques.

Procedure

Mandibulectomy can be classified into three types: marginal, segmental, and hemi-mandibulectomy.

• Marginal Mandibulectomy: This procedure involves the removal of a portion of the mandible without affecting the continuity of the jaw. It is typically performed for tumors that have not invaded the bone deeply.
• Segmental Mandibulectomy: This procedure involves the removal of a segment of the mandible, disrupting the continuity of the jaw. It is usually performed for tumors that have deeply invaded the bone.
• Hemi-Mandibulectomy: This procedure involves the removal of one half of the mandible. It is performed for extensive tumors that have spread across a large portion of the jaw.

Following the removal of the tumor and affected bone, reconstructive surgery may be performed to restore the function and appearance of the jaw. This may involve the use of bone grafts, prosthetics, or tissue flap procedures.

Complications

As with any surgical procedure, mandibulectomy carries potential risks and complications. These may include infection, bleeding, nerve damage resulting in numbness or weakness, difficulty in speaking or swallowing, and aesthetic changes.

Prognosis

The prognosis following mandibulectomy largely depends on the type and stage of the tumor, the patient's overall health, and the success of the reconstructive surgery. Regular follow-up care is essential to monitor for potential recurrence of the tumor and to manage any long-term complications.

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