Midline Mandibulotomy Approach For Oral Cavity And Oropharynx Tumors: Long-Term Experience In A Single Institution

Purpose: To describe our clinical experience with the use of the midline mandibulotomy approach for oral cavity and oropharynx tumors. Methods: : Charts were reviewed retrospectively for 67 consecutive patients who underwent mandibulotomies over a 15-year period (2002-2017) as part of their treatment for oral and oropharyngeal malignancies, with an average follow-up of 57.7 months. Results: : Sixty-seven patients underwent a mandibulotomy. There were 59 males (88%) with a mean age of 56.9 years and eight females (12%) with a mean age 56.5 years. The approach was a midline mandibulotomy in 50 patients (74.6%), a paramedian mandibulotomy in 10 patients (14.9%), and a posterior mandibulotomy in seven (10.44%: angle 1 (1.5%), body 5 (7.5%), and ramus 1 (1.5%). In the group of patients undergoing median or paramedian mandibulotomies, adequate exposure of the lesion was achieved in all cases with a significant lower rate of complications (13,4%) (p<0.005) compared to the posterior mandibulotomy group (37,5%) . Conclusions: : The results of the study confirm that the anterior mandibulotomy approach provides excellent exposure for oral and oropharyngeal tumors, with a significant lower complication rate compared to the posterior mandibulotomy approach.Until minimally invasive Robotic technology is not widespread, conventional techniques such as midline mandibulotomy approaches, with “modern-times” refinements still have their place in head and neck oncology surgery