Mandibular reconstruction using intraoral microvascular anastomosis following removal of an ameloblastoma

Abstract

Ameloblastoma is a histologically benign, locally aggressive tumor arising from the odontogenic ectoderm. It accounts for 1% of all oral tumors and for 9% to 11% of all odontogenic tumors. In up to 96.6%, the tumor can be found in the mandible, predominantly in the molar region. High recurrence rates of up to 90% have been described with conservative treatment. Recurrences most often occur after 2 to 5 years. After radical resection, significantly lower recurrence rates have been reported, sometimes as low as 3.6%. As a consequence, when recurrence rate is the main concern, there is a tendency to prefer radical resection of the ameloblastoma. Microvascular segmental reconstruction of the mandible that uses an intraoral anastomosis technique has not been described in the current literature. Therefore, the present study aimed at extending the armamentarium of bony microvascular reconstruction in cases of segmental mandibulectomy by describing an intraoral microvascular anastomosing technique.