Long-term results after mandibular continuity resection in infancy: the role of autogenous rib grafts for mandibular restoration. 2006

André Eckardt, and Gwen Swennen, and Enno L Barth, and Peter Brachvogel
Department of Oral and Maxillofacial Surgery, Hannover Medical University, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. prof.eckardt@gmx.net

Reconstruction of mandibular defects after tumor resection in infants is a particular challenge. Although autogenous rib grafts have no relevance nowadays for restoration of mandibular bone defects after ablative tumor surgery because of limited bone stock and the availability of other donor areas, they are a useful surgical alternative after tumor surgery in infants. We here report on a 6-month, 5-year, and 10-year follow-up of three children who were diagnosed with benign tumors of the mandible with osseous destruction at the ages of 4 months, 6 months, and 2 years, respectively. Histologic diagnoses were melanotic neuroectodermal tumor, hemangioendothelioma of the mandible, and ameloblastoma. After continuity resection of the mandible, latero-mandibular bone defects were restored using autogenous rib grafts. Both clinical and radiologic follow-up visits in all children were performed to assess growth of the facial skeleton as well as the mandibular growth. Cephalometric measurements on Panorex films and three-dimensional computed tomographic scans revealed slight vertical growth excess and transversal growth inhibition of the reconstructed mandible in comparison with the nonoperated side. Although further growth of rib grafts is difficult to predict and occlusal disharmony may occur because of physiologic maxillary growth and growth of the unaffected mandible, we think that autogenous rib grafts can be ideally used for restoration of mandibular continuity defects in newborns and young children. Clinical follow-up visits on a yearly basis and orthodontic controls are useful for early orthodontic treatment of growth deficits. Further corrective surgery with bone augmentation or osseous distraction is required after completion of growth of the facial skeleton.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D008334 Mandible The largest and strongest bone of the FACE constituting the lower jaw. It supports the lower teeth. Mylohyoid Groove,Mylohyoid Ridge,Groove, Mylohyoid,Grooves, Mylohyoid,Mandibles,Mylohyoid Grooves,Mylohyoid Ridges,Ridge, Mylohyoid,Ridges, Mylohyoid
D008339 Mandibular Neoplasms Tumors or cancer of the MANDIBLE. Mandibular Neoplasm,Neoplasm, Mandibular,Neoplasms, Mandibular
D008445 Maxillofacial Development The process of growth and differentiation of the jaws and face. Development, Maxillofacial,Developments, Maxillofacial,Maxillofacial Developments
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006390 Hemangioendothelioma A neoplasm derived from blood vessels, characterized by numerous prominent endothelial cells that occur singly, in aggregates, and as the lining of congeries of vascular tubes or channels. Hemangioendotheliomas are relatively rare and are of intermediate malignancy (between benign hemangiomas and conventional angiosarcomas). They affect men and women about equally and rarely develop in childhood. (From Stedman, 25th ed; Holland et al., Cancer Medicine, 3d ed, p1866) Endothelioma, Vascular,Hemangio-Endothelioma,Endotheliomas, Vascular,Hemangio Endothelioma,Hemangio-Endotheliomas,Hemangioendotheliomas,Vascular Endothelioma,Vascular Endotheliomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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