Abstract
Lateral temporary mandibulotomy (mandibular swing, mandibular split) is a very favou- rable approach in surgical treatment of oropharyngeal carcinoma. Frequent complications in the healing of osteosynthesis during postoperative radiotherapy limit to some extent successful use of this procedure.
In our retrospective study we investigate the incidence of these complications and look for the risk factors connected with such unfavourable development. Out of 203 patients treated by surgery in a period of 4.5 years lateral temporary mandibulotomy was used in 31 patients (15%).
Twenty-nine of them were postoperatively irradiated. Logistic regression was used for analyzing the relation of healing of osteosynthesis and the age of the patient, the location of the tumour, the classification T and N, the surgeon, the interval between the operation and the beginning of radiotherapy, the dose of radiation and to oncological outcome 12 months after the treatment in these 29 patients.
A complication of healing of the mandible developed in 12 patients during the 12 months after the completion of therapy. In 2 patients only intraoral denudation of the plate occurred and in 10 patients a fistula developed.
All patients with complicated healing were treated in the first place conservatively by antibiotics, which led in one half of the cases to healing. Surgical intervention was necessary in 6 cases, in three cases out of six segmental mandibulotomy was inevitable (10% of the whole group).
Risk factors for the delayed healing of the mandibular osteotomy were not discovered, the age of the patients was of all parameters the closest to significance. Despite a higher complication rate we consider temporary mandibulotomy indicated even in case of planned postoperative radiotherapy.
More careful indication of this approach in elderly patients is advisable.