Reconstruction of the mandible continues to be one of the greatest challenges of head and neck reconstructive surgery. The ultimate goal is to restore the functional and cosmetic integrity of the mandible in one stage without compromising oncologic principles. The myriad list of reconstructive possibilities includes plating, vascularized bone grafts, and the use of alloplastic materials.
See also pp 745-749.
Shockley et al1 present the experience of the University of North Carolina, Chapel Hill, with 19 patients using metallic reconstructive plates with soft-tissue coverage. Their overall success rate of 79% is consistent with the results reported elsewhere and adds support to using this option when the circumstances warrant. The 50% complication rate using the plate in combination with pectoralis major myocutaneous flaps is distressing, but too few patients are included in the study to pinpoint the cause of the problem.
Several issues are still controversial in the use of
Shockley WW, Weissler MC, Pillsbury HC, Meyers AD. Immediate Mandibular Replacement Using Reconstruction Plates. Arch Otolaryngol Head Neck Surg. 1991;117(7):750. doi:10.1001/archotol.1991.01870190062012