An approach to marginal mandibulectomy and reconstruction for lower gingival carcinoma: A case report

Introduction: The patients with early stage, clinically node-negative oral squamous cell carcinomas are usually treated with oral surgical excision of primary tumor. Marginal mandibulectomy of posterior mandible is difficult with an adequate safety margin via an intraoral. The cheek-splitting incisi...

Full description

Bibliographic Details
Main Authors: Akio Shibata, Kou Kawahara, Takashi Oguri, Memi Ohira, Tasuku Oriyama, Akihiro Niwa
Format: Article
Language:English
Published: Elsevier 2020-09-01
Series:Oral and Maxillofacial Surgery Cases
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S221454192030033X
Description
Summary:Introduction: The patients with early stage, clinically node-negative oral squamous cell carcinomas are usually treated with oral surgical excision of primary tumor. Marginal mandibulectomy of posterior mandible is difficult with an adequate safety margin via an intraoral. The cheek-splitting incision allows marginal resection at the posterior mandible under direct vision and it can avoid invasion to the neck region. The Buccal fat pad flap (BFP) grafting is considered feasible for the reconstruction of surgically induced defects, because of it has a high success rate due to BFP's rich vascularity, proximity to the recipient site, low donor-site morbidity, and simple surgical procedure for grafting. The combination of BFP and The mucosal defect covered with fibrin glue and polyglycolic acid sheet (MCFP technique) can makes early intake after surgery, excellent wound-healing and pain-relieving effects. Case report: We reported a case of squamous cell carcinoma arising at the posterior mandibular gingiva that was treated by marginal mandibulectomy via a cheek-splitting transbuccal approach, reconstructed the defect after surgery using a BFP covered with MCFP technique. Conclusion: A major advantage of this approach is that it obtains an adequate margin of the posterior site without requiring a cervical incision thus allowing early intake after surgery and excellent wound-healing and pain-relieving effects.
ISSN:2214-5419