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At the recent fall meeting of the American Academy of Facial Plastic and Reconstructive Surgery in Chicago, Robert H. Maisel, MD, and colleagues from the University of Minnesota, Minneapolis, presented their experience with a midline mandibular osteotomy and mandibular swing to gain exposure for resection of oral cavity and oropharyngeal carcinomas. In patients where the mandible is free of tumor, they prefer this technique to segmental resection, because it gives a better functional and cosmetic result. The authors prefer a stepped symphyseal osteotomy to angle or parasymphyseal approaches. They point out that both flexion- and tension-type forces act on the mandible, and recommend the use of two miniplates to close the osteotomy. Upper neck dissection greatly fascilitates this approach. When properly done, they have had no problem giving postoperative radiation therapy. They feel that the superior exposure this approach allows, along with the sparing of the mental nerve, makes it
DENNENY JC. The Midline Mandibular Osteotomy and Mandibular Swing. Arch Otolaryngol Head Neck Surg. 1988;114(2):121. doi:10.1001/archotol.1988.01860140019008
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