Reconstruction of a large mandibular defect utilizing temporary zygomatic-ramal fixation and bilateral Risdon incisions

J Craniofac Surg. 2004 Jan;15(1):16-9. doi: 10.1097/00001665-200401000-00007.

Abstract

Ameloblastoma is a benign, invasive, odontogenic tumor of the jaws that predominantly affects the mandible. Despite the benign nature of these lesions, there is a high rate of local recurrence after curettage, which usually requires resection. The traditional surgical approach for resection of ameloblastomas, via either mandibulotomy or mandibulectomy, has been through lower lip-splitting incisions, which are associated with significant functional and esthetic sequelae. A case is presented here in which less invasive Risdon and intraoral degloving incisions were used in combination with temporary zygomatic-ramal fixation to maintain occlusion after resection of a large mandibular ameloblastoma. The bilateral Risdon approach provided wide access to the mandible, allowing an angle-to-angle resection to be performed. This approach also provided adequate exposure for an osteocutaneous fibula free flap reconstruction to be performed, with 100% flap survival. At 1 year of follow-up, there were minimal functional and esthetic defects. This approach represents a less invasive alternative that provides access to the mandible for curative resection of benign tumors with minimal postoperative sequelae.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Ameloblastoma / surgery*
  • Humans
  • Jaw Fixation Techniques*
  • Male
  • Mandible / surgery*
  • Mandibular Neoplasms / surgery*
  • Neoplasm Recurrence, Local / surgery
  • Surgical Flaps
  • Zygoma / surgery