Posterior marginal mandibulectomy for cancer of the oral cavity and oropharynx. Experience with 14 clinical cases

: Marginal mandibulectomies are now widely performed in the anterior aspect of the mandible providing that the preoperative clinical and radiologic evaluation shows no bone invasion. These marginal resections can be extended to the posterior area. Molar, retromolar and ascending ramus resections can be performed. This removes the upper bone segment preserving the dental canal whenever possible. From 1990, 14 patients were treated with this technique for carcinoma of the retromolar triangle (9 cases) and oropharynx (5 cases). 11 different flaps were used to cover the soft tissue defect and 3 direct sutures were performed. Eleven patients underwent postoperative radiotherapy with a mean dose of 58 Gray. Median follow-up was 32 months. Functional and cosmetic results were very satisfactory due to preservation of mandibular continuity. We found no osteomyelitis, postoperative fracture or radionecrosis. This technique avoids a segmental resection in some well-defined cases and the disability produced as a result of this treatment. There is therefore, no need for complex reconstruction and the operating time is shortened in fragile patients.