Usefulness of Preoperative Simulation on Mandibular Alveoplasty for Mandibular Prosthesis after Marginal Mandibulectomy and Rectus Abdominal Muscle Reconstruction

Abstract

It is important for head and neck tumor patients to maintain their quality of life after tumor resection. These patients may suffer from speech disability, chewing disability, swallowing dysfunction due to mandibular defect, and limited tongue movement and mass after subtotal glossectomy and flap reconstruction. This report describes a preprosthetic surgical treatment including digital surgical simulation and a multidisciplinary approach. Three-dimensional surgical simulation was performed using digitalized CT and study cast images. The combination of skeletal and soft tissue images enables us to predetermine the tissue margin and shape for a mandibular alveoplasty. This method was applied to a 65-year-old male patient who underwent marginal mandibulectomy and rectus abdominal muscle reconstruction, who had limited tongue movement and no space for a prosthesis. Through collaboration among a plastic surgeon, oral surgeon and maxillofacial prosthodontist, a surgical guide was produced from the simulation by a 3D printer, and the mandibular prosthesis was delivered after the alveoplasty. It is suggested that digital simulation and a multidisciplinary approach are effective for installing dentures for patients with head and neck tumors.