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Anterior mandibulotomy for oral and oropharyngeal tumours

Published online by Cambridge University Press:  29 June 2007

Ajit Man Singh*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, New Delhi-110029, India
Sudhir Bahadur
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, New Delhi-110029, India
D. A. Tandon
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, New Delhi-110029, India
R. M. Pande
Affiliation:
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi-110029, India
*
Dr Ajit Man Singh, ENT Department, Blackburn Royal Infirmary, Blackburn BB2 3LR

Abstract

In the last six years, anterior mandibulotomy was used to approach tumours of the oropharynx and oral cavity in 39 cases. Twenty-six of these had primary lesions in the anterior two-thirds of the tongue. Eight cases had lesions in the base tongue, three in the cheek, and two in the tonsil. Twenty-six cases had T3 tumours, nine had T2 lesions, and four had T4 tumours. Twenty-five patients received post-operative radiotherapy. In 16 cases the mandibulotomy was combined with a marginal mandibulectomy. In 23 cases reconstruction was carried out using a pectoralis major myocutaneous flap. Adequate margins on histopathology obtained in all but eight patients. Bone-related complications occurred in only three patients, all of whom were previously irradiated. Thus the anterior mandibulotomy provides excellent exposure for oral and oropharyngeal tumours, with low complication rate, and avoidance of segmental mandibulectomy.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1993

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References

Butlin, H. T. (1885) Diseases of the Tongue. Cassel, London, p. 331.Google Scholar
Cohen, J. J., Marentette, L. J., Maisel, R. H. (1988) The mandibular swing-stabilization of the midline mandibular osteotomy. Laryngoscope 98: 11341142.CrossRefGoogle ScholarPubMed
Davidson, J., Freeman, J., Bin, D. (1989) Mandibulotomy in the irradiated patient. Archives of Otolaryngology 115: 497499.CrossRefGoogle ScholarPubMed
De Santo, L. W., Whicher, J. H., Devine, K. D. (1975) Mandibular osteotomy and lingual flaps: use in patients with carcinoma of the tonsil and tongue base. Archives of Otolaryngology 101: 652655.Google Scholar
Dubner, S., Spiro, R. H. (1991) Median mandibulotomy: a critical assessment. Head and Neck Surgery 13: 389393.Google ScholarPubMed
McGregor, I. A., MacDonald, D. G. (1983) Mandibular osteotomy in surgical approach of the oral cavity. Head and Neck Surgery 5: 457462.CrossRefGoogle ScholarPubMed
Sardi, A., Waters, P. (1991) Modified mandibular swing for resection of cancers of the oropharynx. Head and Neck Surgery 13: 394397.Google ScholarPubMed
Spiro, R. H., Gerold, F. P., Strong, A. W. (1981) Mandibular ‘swing’ approach for oral and oropharyngeal tumours. Head and Neck Surgery 3: 371378.Google Scholar
Spiro, R. H., Gerold, F. P., Shah, J. P. et al. , (1985) Mandibulotomy approach to oropharyngeal tumours. American Journal of Surgery 150: 466469.Google Scholar
Spencer, W. G., Cade, S. (1931) Diseases of the Tongue. P. Blaikis-ton's Sons, Philadelphia, p. 328331.Google Scholar
Sullivan, P. K., Fabion, R., Driscoll, D. (1992) Mandibular osteo-tomies for tumour expiration: The advantages of rigid fixation. Laryngoscope 102: 7380.CrossRefGoogle Scholar
Trotter, W. (1920) Method of lateral pharyngotomy for exposure of large growths in epilaryngeal region. Journal of Laryngology and Otology 35: 289295.CrossRefGoogle Scholar