RICOSTRUZIONE DELLA MANDIBOLA DOPO RESEZIONE COMPOSITA PER CARCINOMA DEL CAVO ORALE: VANTAGGI DELLE PROTESI IN TITANIO A GABBIA

Surgical treatment of advanced (T4) oral cancer usually requires 'en block' composite resection including the tumour along with a portion of the floor of the mouth, the laterocervical lymph nodes and a segment of the mandible (if involved or closer than 1 cm to the tumour). In our experience reconstruction by positioning a titanium mandibular prosthesis covered by pectoralis major myocutaneous flap still represents the simplest method of reconstruction for these patients. This reconstructive approach is best suited for critical patients, where microvascular reconstruction has specific contraindications. A recently introduced new kind of mesh tray titanium prosthesis seems to have significant advantages for reconstruction of the mandible when compared with the mini-plate system. In this paper the Authors evaluate the preliminary results obtained in a limited series of patients with oral cancer (T4), that underwent composite resection and immediate reconstruction by Mesh tray titanium prosthesis and pectoralis major myocutaneous flap transposition.