Minimally Invasive Mandibular Microsurgery: A Systematic Review and Meta-analysis
Background:. Microsurgical advances have led to minimally invasive approaches for mandibular reconstruction. Currently, no resource compares all minimally invasive microvascular mandibular reconstruction (MIMMR) treatment options. Methods:. All known cases of MIMMR were identified following the Pref...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2023-01-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004733 |
| _version_ | 1797947151546843136 |
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| author | Kerilyn N. Godbe, MD Michaela K. O’Connor, BS Lauren M. Sinik, MD Dylan T. Vance, BS Niaman Nazir, MD, MPH Ravi K. Garg, MD |
| author_facet | Kerilyn N. Godbe, MD Michaela K. O’Connor, BS Lauren M. Sinik, MD Dylan T. Vance, BS Niaman Nazir, MD, MPH Ravi K. Garg, MD |
| author_sort | Kerilyn N. Godbe, MD |
| collection | DOAJ |
| description | Background:. Microsurgical advances have led to minimally invasive approaches for mandibular reconstruction. Currently, no resource compares all minimally invasive microvascular mandibular reconstruction (MIMMR) treatment options.
Methods:. All known cases of MIMMR were identified following the Preferred Reporting Items for Systematic Reviews, Meta-Analyses guidelines, and our own surgical experience. Patient demographics, MIMMR type [submandibular (SM), modified facelift/retroauricular (MFL/RA), or intraoral (IO)], methodology, and clinical outcomes were analyzed with the Fisher exact and Kruskal-Wallis tests.
Results:. Forty-seven patients underwent MIMMR. Ameloblastoma was the most common pathology treated using all approaches, and MFL/RA was the only approach used to treat squamous cell carcinoma (P = 0.0103). Reconstruction was reported for large, bilateral defects only via the SM or IO approach (P = 0.0216). The iliac crest or fibula was used as a donor site. The facial artery was the most common recipient vessel using the IO and SM approaches, whereas the superior thyroid and external carotid vessels were the most common in the MFL/RA approach (P < 0.0001). Virtual planning was used in all cases performed via an IO approach, 80.0% of cases using an SM approach, and no MFL/RA cases (P < 0.0001). Good aesthetic and functional outcomes were reported for every patient, and there was no difference in complication rates (P = 0.2880).
Conclusions:. Minimally invasive approaches are safe and effective treatment options for patients requiring mandibular microsurgery, usually in the setting of benign pathology. The IO and SM approaches usually rely on the facial vessels, whereas the MFL/RA approach permits access to the superior thyroid and external carotid vessels and cervical lymphadenectomy. |
| first_indexed | 2024-04-10T21:22:17Z |
| format | Article |
| id | doaj.art-e42a5fcd76a4432aaa257632d8c2067f |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-10T21:22:17Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-e42a5fcd76a4432aaa257632d8c2067f2023-01-20T02:34:49ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-01-01111e473310.1097/GOX.0000000000004733202301000-00002Minimally Invasive Mandibular Microsurgery: A Systematic Review and Meta-analysisKerilyn N. Godbe, MD0Michaela K. O’Connor, BS1Lauren M. Sinik, MD2Dylan T. Vance, BS3Niaman Nazir, MD, MPH4Ravi K. Garg, MD5From the * Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kans.† University of Kansas School of Medicine, Kansas City, KansFrom the * Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kans.† University of Kansas School of Medicine, Kansas City, Kans‡ Department of Population Health, University of Kansas Medical Center, Kansas City, Kans.From the * Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kans.Background:. Microsurgical advances have led to minimally invasive approaches for mandibular reconstruction. Currently, no resource compares all minimally invasive microvascular mandibular reconstruction (MIMMR) treatment options. Methods:. All known cases of MIMMR were identified following the Preferred Reporting Items for Systematic Reviews, Meta-Analyses guidelines, and our own surgical experience. Patient demographics, MIMMR type [submandibular (SM), modified facelift/retroauricular (MFL/RA), or intraoral (IO)], methodology, and clinical outcomes were analyzed with the Fisher exact and Kruskal-Wallis tests. Results:. Forty-seven patients underwent MIMMR. Ameloblastoma was the most common pathology treated using all approaches, and MFL/RA was the only approach used to treat squamous cell carcinoma (P = 0.0103). Reconstruction was reported for large, bilateral defects only via the SM or IO approach (P = 0.0216). The iliac crest or fibula was used as a donor site. The facial artery was the most common recipient vessel using the IO and SM approaches, whereas the superior thyroid and external carotid vessels were the most common in the MFL/RA approach (P < 0.0001). Virtual planning was used in all cases performed via an IO approach, 80.0% of cases using an SM approach, and no MFL/RA cases (P < 0.0001). Good aesthetic and functional outcomes were reported for every patient, and there was no difference in complication rates (P = 0.2880). Conclusions:. Minimally invasive approaches are safe and effective treatment options for patients requiring mandibular microsurgery, usually in the setting of benign pathology. The IO and SM approaches usually rely on the facial vessels, whereas the MFL/RA approach permits access to the superior thyroid and external carotid vessels and cervical lymphadenectomy.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004733 |
| spellingShingle | Kerilyn N. Godbe, MD Michaela K. O’Connor, BS Lauren M. Sinik, MD Dylan T. Vance, BS Niaman Nazir, MD, MPH Ravi K. Garg, MD Minimally Invasive Mandibular Microsurgery: A Systematic Review and Meta-analysis Plastic and Reconstructive Surgery, Global Open |
| title | Minimally Invasive Mandibular Microsurgery: A Systematic Review and Meta-analysis |
| title_full | Minimally Invasive Mandibular Microsurgery: A Systematic Review and Meta-analysis |
| title_fullStr | Minimally Invasive Mandibular Microsurgery: A Systematic Review and Meta-analysis |
| title_full_unstemmed | Minimally Invasive Mandibular Microsurgery: A Systematic Review and Meta-analysis |
| title_short | Minimally Invasive Mandibular Microsurgery: A Systematic Review and Meta-analysis |
| title_sort | minimally invasive mandibular microsurgery a systematic review and meta analysis |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004733 |
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