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Mandibular reconstruction in head and neck cancer: which is the gold standard?

  • Review Article
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Introduction

The aim of this study is to perform a systematic review to compare the outcomes of the different surgical options for mandibular reconstruction in head and neck cancer.

Material and methods

93 articles were selected. Four groups were identified: titanium plate without flaps, titanium plate covered by soft tissue flap, bone tissue flaps and double flaps. We compared patients’ characteristics, site of mandibulectomy, type of reconstruction and complications.

Results

4697 patients were reported. The groups were not homogeneous regarding the type of defect and the treatment history. A significant difference in terms of post-operative complications was found between group 1 and group 2 (p < 0.00001), and between group 2 and group 3 (p < 0.00001). Total complications rate for group 4 was significantly higher when compared to group 3 (p < 0.00001), but no significant difference was found with group 2.

Conclusion

These results suggest that mandibular reconstruction using a microvascular bone flap is the best surgical option in patients without significant comorbidities.

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Authors and Affiliations

  1. Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria

    Gabriele Molteni, Luca Gazzini, Andrea Sacchetto, Riccardo Nocini, Lara Valentina Comini, Valerio Arietti, Luca Giovanni Locatello & Giuditta Mannelli

  2. Head and Neck Department, University Hospital of Verona, Verona, Italy

    Gabriele Molteni

  3. Department of Surgery, Dentistry and Pediatrics, University of Verona, Verona, Italy

    Gabriele Molteni, Riccardo Nocini & Valerio Arietti

  4. Otorhinolaryngology-Head and Neck Surgery Department, San Maurizio Hospital, Bolzano, Italy

    Luca Gazzini

  5. Department of Otolaryngology, Ospedale San Bortolo, AULSS 8 Berica, Vicenza, Italy

    Andrea Sacchetto

  6. Otorhinolaryngology Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Lara Valentina Comini

  7. Department of Otorhinolaryngology, Sant’Antonio Abate Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Tolmezzo, Italy

    Luca Giovanni Locatello

  8. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Giuditta Mannelli

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Molteni, G., Gazzini, L., Sacchetto, A. et al. Mandibular reconstruction in head and neck cancer: which is the gold standard?. Eur Arch Otorhinolaryngol 280, 3953–3965 (2023). https://doi.org/10.1007/s00405-023-08050-5

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