OBJECTIVE: The surgical approach for resection and reconstruction of tongue cancer (TSCC) with or without the lip-splitting incision is controversial. This study introduced a modified approach without lip-splitting and the clinical results were assessed.
METHODS: Sixty-eight TSCC patients underwent surgery using the modified submandibular mandibulotomy (MSMM) approach without lip-splitting, and another matched 68 patients using lip-splitting mandibulotomy (LSM) approach were enrolled in this study. The clinical results including intraoperative relevance and surgical morbidities, survival status, facial appearance and scar scores, function of lower lip, and quality of life (QOL) were evaluated.
RESULTS: The primary tumors were en bloc resected through the MSMM approach with excellent tumor exposure and R0 resection margins as LSM approach. The survival status and complications were similar in both groups. The function of lower lip was better in patients of MSMM group at 1 month after surgery. The MSMM approach was associated with significantly better facial appearance and recreation compared to LSM approach by scar scores and QOL assessment.
CONCLUSIONS: The MSMM approach without lip-splitting achieves similar tumor control, better aesthetic results, and QOL compared to LSM approach. It is a safe and effective surgical approach for patients with TSCC.
CONCLUSIONS: The MSMM approach without lip-splitting is oncological safety in tongue cancer surgery and is scrutinized as one part of the treatment concept for better aesthetic results.

暂无摘要。

OBJECTIVE: Retrospective clinical evaluation and biomechanical tests were performed to compare the primary stability and the rate of pseudarthrosis formation after irradiation for two types of mandibular split osteotomies: the stairstep osteotomy (SSO) and the straight-line osteotomy (SLO).
METHODS: The postoperative occurrence of pseudarthrosis was retrospectively analysed in 46 non-consecutive clinical cases of SSO and SLO between 2003 and 2013. Biomechanical tests were performed on 12 standardised synthetic mandibles (Synbone) to compare the SSO and SLO approaches. Two 2.0 mm monocortical miniplates (Medartis) were used for osteosynthesis. The artificial mandible specimens were loaded to 300 N on the Mandibulator test bench while interfragmentary motion was measured using the PONTOS optical measurement device.
RESULTS: The retrospective clinical analysis showed a rate of pseudarthrosis of 19% in the SLO group versus only 5% in the SSO group (p = 0.17). In the biomechanical investigation, the average interfragmentary movement was 14.3 ± 7.70 for the SLO group and 4.57 ± 2.33 for the SSO group under a maximum load of 300 N, resulting in a statistically significant difference between the two approaches (p = 0.014).
CONCLUSIONS: To minimise the rate of postoperative pseudarthrosis formation, SSO is superior to SLO for mandibular split procedures, because SSO provides greater resistance to vertical loads and allows less interfragmentary movement.
METHODS: 2C (Outcomes research).

The mandibular swing approach is a surgical approach for the resection of malignant lesions localized in the posterior oral cavity and oropharynx. We analyzed 15 years of experience with fixation of the straight midline mandibulotomy and compared two fixation methods: lag screws and miniplates. A total of 117 patients underwent a straight midline mandibulotomy during the study period; 85 had fixation with two lag screws and 32 with two miniplates. The overall complication rate was low and there was no significant difference in complication rate regarding the fixation method (9% for miniplates vs. 7% for lag screws). The most serious complication over the whole study period was non union, which occurred in only two patients, followed by orocutaneous fistula and infection. Radiotherapy did not cause serious complications and is not regarded as hazardous in midline mandibulotomy patients. We conclude that lag screw fixation is at least as safe as miniplate fixation, but because of better fragment compression, offers faster bone healing.