The Utility of Paramedian Mandibulotomy for Resection of Oral Cavity and Oropharynx Cancer

Oh, So Jung; Lee, Chul Hee; Kim, Jin Hwan; Rho, Young Soo

Abstract

BACKGROUND AND OBJECTIVES: Mandibulotomy approach is the most popular method for resection of oral cavity and oropharyngeal cancers because of wide surgical exposure with minimal morbidities. The purposes of this study are to evaluate the utility and morbidity of the mandibulotomy approach.
SUBJECTS AND METHOD
A total of 191 patients who had cancer in the oral and oropharynx were surgically treated between 1995 and 2005. Among them, 51 patients underwent mandibulotomy. The types of the mandibular osteotomy were consisted of the paramedian osteotomy in 44 patients.
RESULTS
First, only 10% (11 of 110) of the oral cavity cancer patients were required to use the mandibulotomy approach for primary resection. In the oropharynx cancer, the mandibulotomy rates was 49% (40 of 81). The rates of the mandibulotomy according to T stages were as follows: T1, 0% (0 of 27), T2; % (17/92), T3; 50% (24/48), and T4, 42% (10 of 24). Second, an average mean time to start oral diet after the mandibulotomy was 14th day and average mean duration of the tracheostomy until decannulation in the cannula was 19th days. Third, the complication rate related with the paramedian mandibulotomy related was 23% and the most of the complications could be managed with conservative treatment.
CONCLUSION
The paramedian mandibulotomy with the stair-step osteotomy and miniplate fixation is an excellent surgical approach for posterior lesion of oral cavity cancer and oropharyngeal advanced tumors.