Abstract
Objectives
To reveal the change patterns of the facial soft tissue after applying mandibular reconstruction.
Materials and Methods
16 Patients with mandibular benign tumor were recruited in this retrospective study. For all patients, segmental mandibular osteotomy and concurrent reconstruction using vascularized iliac flap were conducted. The soft tissue thickness of patients’ lower face was measured with CT scans before surgery, 1 week, 6 months and 1 year after surgery. The time-dependent changes of tissue thickness were analyzed.
Results
The most significant tissue swelling was 28.86%, at 1 week after the surgery. The average increase of tissue thickness was 4.78 ± 5.30 mm across patient. After 1 year of the surgery, tissue thickness decreased to the level before operation or the level of the healthy side. The thickness of the low-density tissue fluctuated mildly, while the thickness of the high-density tissue fluctuated significantly. The disuse atrophy of the masseter occurred 1 week after the surgery, and was reversed after 1 year. The removal of the submandibular gland caused depression in submandibular area, which intensified over time.
Conclusion
Across patients, soft tissue thickness in the lower face after mandibular osteotomy and reconstruction increased significantly 1 week after the surgery, and decreased over time. After 1 year, tissue thickness went back to the pre-surgery level, where matched up with the healthy side.
Clinical relevance
We documented the change patterns of the facial soft tissue after mandibular reconstruction. These results can help improve the planning of virtual surgeries and the timing for aesthetic assessment.
Trial Registration
ClinicalTrials.gov Identifier: ChiCTR2100054103.
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Data availability
We confirm that the data supporting the findings of this study are available within the article.
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Acknowledgements
The authors would like to gratefully acknowledge Tianyi Li for revision and language editing.
Funding
Funding were provided by Capital’s Funds for Health Improvement and Research, 2020–2-4102, the National Program for Multidisciplinary Cooperative Treatment on Major Diseases, PKUSSNMP-202015, and The Capital Health Research and Development of Special, 2022–2-4102.
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Ding MK, Shan XF, and Cai ZG conceived and designed the study. Ding MK and Li CQ measured and analyzed the data. Ding MK wrote the manuscript and Kang YF revised. Shan XF and Cai ZG organized and supervised the whole study. All authors read and approved the final manuscript.
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This study was approved by the institutional ethics committee (PKUSSIRB-202055065a), and written informed consent was obtained from participants.
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Ding, M., Li, C., Kang, Y. et al. Changes of the facial soft tissue after mandibular reconstruction using vascularized iliac flap. Clin Oral Invest 27, 6619–6625 (2023). https://doi.org/10.1007/s00784-023-05268-9
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DOI: https://doi.org/10.1007/s00784-023-05268-9