Mandibular reconstruction of the chin area in patients with tumors of the maxillofacial region and oral mucosa

Background. Locally advanced squamous cell carcinoma of the oral cavity invades the mandible in 13–38 % of cases. Even a small segmental resection of the mandible, for instance, in the chin area, causes significant functional and cosmetic impairment and requires immediate reconstruction of the bone defect. Currently available methods of defect closure require a comparative assessment.

Materials and methods. This article is based on the outcome data from patients with mandibular tumors treated from 1998 through 2018. We identified 471 cases of mandibular surgery including marginal resection and midline mandibulotomy; 203 (43.1 %) patients underwent segmental resection. Of them, we selected 99 patients with an isolated chin defect combined either with a mandibular body defect or with a subtotal defect in the mandible.

Results. In this study, we analyzed the treatment outcomes in patients with primary and secondary mandibular tumors involving the chin as the most difficult for reconstruction from the point of view of the surgeon and the most important for the patient from the functional and aesthetic point of view.

Conclusions. A mandibular defect located in the chin area requires immediate reconstruction. The preferable method of defect closure is the application of a reconstruction plate with a musculocutaneous flap or implantation of vascularized bone grafts. Implantation of a fibular free flap is preferable for the closure of extensive mandibular defects involving the chin area. 

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