The results obtained by means of methods or materials used for the mandibular reconstruction have not been always satisfactory. We analyzed the metallic plates used for repairing the mandibular defects of 52 cases. We also examined the clinical courses of the metallic plates used for reconstruction after surgery of the both malignant and benign diseases or minor and malor mandibulectomies.
Segmental mandibulectomy was more frequently applied than marginal and hemi-mandibulectomy. In most cases, the mandibular defects were repaired immediately. The plates were made of titanium or stainless steel. The shape of the plates we used most frequently was the straight type, followed by the angled type and then condylar head type. Mandibular reconstruction was performed solely with metallic plates or in combination with bone grafts. In reconstruction for defects of the surrounding soft tissue delto-pectoral flap, pectoralis malor myocutaneous flap, sternocleidomastoid myocutaneous flap, free latissimus dorsi myocutaneous flap were also used.
During the 15-year follow-up period, metallic plates were removed from 12 of 52 cases (23%). The metallic plates of five out of 12 cases were removed because of exposure of metallic plates to the surface of submandibular skin, which resulted from insufficiency of surrounding soft tissue. The remaining 7 cases were one infection of the surgical wound, one loosed screw, one plate fracture, 2 tumor recurrences and 2 others. The removed metallic plates were more frequently seen in the cases after major segmental and hemi-mandibulectomy than after marginal and minor segmental resection. In 18 of 22 cases (82%) with benign diseases and 22 of 30 cases (73%) with malignant tumors, mandible with the metallic plates used for reconstruction of the mandibular defects led to be functionally and morphologically stable in postoperative clinical course.
