구강암 절제를 위한 하악골이단술: 합병증과 기여인자

MANDIBULOTOMY, A SURGICAL APPROACH FOR ORAL CANCER: ITS COMPLICATIONS AND CONTRIBUTING FACTORS

  • 변성규 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 최은창 (연세대학교 의과대학 이비인후과학교실) ;
  • 박원서 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 이의웅 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 차인호 (연세대학교 치과대학 구강악안면외과학교실)
  • Byun, Seong-Kyu (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Choi, Eun-Chang (Department of Oto-Rhino-Laryngology, College of Medicine, Yonsei University) ;
  • Park, Won-Se (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Lee, Eui-Woong (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Cha, In-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University)
  • 발행 : 2000.08.31

초록

We reviewed 56 patients who received mandibulotomy at Yonsei medical center between 1989 and 1999. We also analysed the complications associated with mandibulotomy and its contributing factors. The complications occur in 16 patients(28.6%) and are classified into two categories; intraoperative and postperative complications. Nonunion was observed in 5 patients and osteoradionecrosis in 5. The patients who received preoperative radiation therapy were more tend to develop nonunion and osteoradionecrosis. This study suggests the benefits of mandibulotomy as a surgical approach to oral cancer: 1. Paramedian osteotomy was recommended for preservation of neurovascular bundle and ease of surgical access. 2. By using thin saw blade, reapproximation was improved with minimal bone loss. 3. osteotomy on anterior mandible which lies outside the usual portals of radiation therapy decreases the incidence of osteoradionecrosis.

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