The clinical situation in which an oral tumour lies close to the mandible, with minimal or macroscopic bone infiltration, oncologically calls for a segmental mandibular resection or hemimandibulectomy. This leads to considerable impaired function and facial disfigurement unless reconstruction is performed. The purpose of this report is to review the literature on reimplantation of frozen autogenous mandible and to propose clinical applications. All papers published over the last 35 years concerning both biological research and clinical experience of reimplantation of frozen mandibular grafts have been evaluated. Follow-up of treated patients, complications and survival rate of the grafts have been analysed. Advantages, disadvantages, problems, limitations and present clinical applications are discussed. The biological and oncological effect of the freezing procedure has been demonstrated on living tissues and on animals; technically it is very simple. Clinical applications concern immediate or delayed reimplantation of frozen autogenous mandible performed in 33 patients with benign tumours and in 30 with oral malignancies. The local success rate for immediate reconstruction of the mandible was 31% after resection of 16 malignant tumours, and 85% after removal of 33 benign tumours. Delayed reconstruction after resection of malignancies was performed in 14 cases and had a success rate as high as 93%. The difficult part of clinical application is to ensure graft survival without exposure, infection and extrusion. No tumour recurrence was observed in the grafted bone up to 52 months. Using the patient's own mandible offers advantages such as perfect morphological appearance, lack of antigeneity and low donor site morbidity. New considerations in the evolution of a successful procedure are coming from our experimental study and clinical pilot study, started in 1997, where we combined a frozen autogenous bone graft and free flap with periostium in order to optimise the graft covering and for bone graft rehabitation.
|Number of pages||5|
|Journal||Rivista Italiana di Chirurgia Plastica|
|Publication status||Published - 2002|
- Frozen graft
- Mandible reconstruction
- Oral cavity cancer
ASJC Scopus subject areas