Medial Mandibulotomies: Is there sufficient space in the midline to allow a mandibulotomy without compromising the dentition?

Journal of Otolaryngology-Head & Neck Surgery

David P Goldstein¹  John Waldron³  Jonathan C Irish¹  Patrick J Gullane¹  Ralph W Gilbert¹  Dale H Brown¹  Eshetu G Atenafu⁴  Robert E Wood²  Hon Biu Chan³  Eric Bissada¹  Tulika Shinghal¹ 

[1] Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Wharton Head and Neck Program, University Health Network, Princess Margaret Hospital, University of Toronto, 610 University Ave 3-952, Toronto, ON M5G 2M9, Canada;Department of Dental Oncology, Ocular and Maxillofacial Prosthetics, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada;Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada;Department of Biostatistics, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada

关键词: Medial;    Dental;    Paramedian;    Median;    Complications;    Mandibulotomy;   

Others  :  861784
DOI  :  10.1186/1916-0216-42-32

 received in 2012-11-29, accepted in 2013-04-28,  发布年份 2013

【 摘 要 】

Objectives

The objective of this study was to determine the frequency of complications in median and paramedian mandibulotomies. In addition, the interdental space in the median and paramedian region was calculated.

Study design

Retrospective study.

Setting

Tertiary care center.

Methods

A retrospective chart review was performed for all cases where a mandibulotomy was performed from 2002 to 2010. 117 charts (61 paramedian and 56 median) were identified. We included data on complications, which fell in the following 2 categories: plate and dental complications. For our second objective, we evaluated 40 different patients with base of tongue or tonsillar cancer treated with intensity modulated radiation therapy (IMRT). The interdental space between the lateral incisors and the canines was electronically calculated on the digital Panorex images.

Main outcome measures

Dental and plate complications were evaluated. We also assessed interdental space.

Results

Patient characteristics were not significantly different. The median group had significantly more dental complications (p=0.0375, RD=0.19 and 95% CI (0.0139-0.3661)). The paramedian group had significantly more plate complications (p=0.0375, RD=0.082 and 95% CI (0.0131-0.1508). The distance between the central incisors was significantly less than the distance between the lateral incisors and canines both at the crestal and apical levels (p=0.0086 and p<0.001).

Conclusions

There are significantly more dental complications in the median approach. There were significantly more plate complications in the paramedian group. In addition, there is significantly less space in the between the median region as compared to the paramedian region. This is the first study that documents the advantage of the paramedian approach for dental complications.

【 授权许可】

   
2013 Shinghal et al.; licensee BioMed Central Ltd.

【 图 表 】

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