Mandibulectomy – Surgery

Mandibulectomy – Surgery

Write Short Note On Hemimandibulectomy.

Answer. Hemimandibulectomy means half of the mandible is removed to excise the lesion which is involving that region.

“Causes Requiring Mandibulectomy”

Types Of Hemimandibulectomy

• Condyle sparing hemimandibulectomy: This method is done for extensive lesions which involve both inferior and posterior borders of the mandible.
  The condyle can be spared if it is not involved.
  Sparing of the condyle allows the reconstruction procedure to be simpler.
  This is because there will be a segment for attchment ofthe reconstruction plate or bone graft.

“Risks Of Mandibulectomy Surgery”

• Disarticulating hemimandibulectomy: This procedure is done for extensive lesions which involve inferior border, posterior border and condyle.
  Condyle removal makes reconstruction a litte more diffilt as the condylar prosthesis has to be placed very carefully in condylar fossa without applying pressure inside the fossa.
  Reconstruction plates are available with the condylar prosthesis for reconstruction of hemimandibulectomy defects.

“What Is Mandibulectomy Surgery”

Basic Procedure for Hemimandibulectomy

• Depending on the extent of involvement a partial or hemimandibulectomy is done.
• Once the inferior border of the mandible is exposed masseter and medial pterygoid are reflected of from the buccal ramus of the mandible.
• Similarly temporalis muscle is reflected of the coronoid process and the mylohyoid muscle from the lingual surface of the mandible.
• A bone cut is made anterior to the lesion extending till the inferior border of the mandible using either a Gigli saw or bur.

“Types Of Mandibulectomy Procedures”

• Once the cut is made the segment is rotated laterally, the inferior alveolar bundle entering the lingula is identifid and ligated.
• The condyle is then freed from the lateral pterygoid muscle and the mandible is disarticulated.
• Hemostasis is achieved and closure is accomplished by approximating the buccal and lingual mucoperiosteal flaps.
• Similarly the lip and sub mandibular incisions are approximated and closed in layers.
• A drain may be inserted to avoid collection of fluid in dead space.
• A pressure dressing should be applied.