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Russia, Sochi, GAZPROM mountain resort

Reconstruction of the mandible

(Mandibular reconstruction, lower jaw repair)

The surgery is focused on reconstructing the shape and functions of the mandible with the use of patient's own tissues.

Alexey Dikarev
Alexey Dikarev,
A leading plastic surgeon specializing in mandibular reconstruction
Before
After
Anesthesia Narcosis
Surgery duration 12 hrs
Residency from 12 days

The clinic you can trust

Anatomy of the mandible

The mandible has the same functions as the maxilla. It participates in chewing, swallowing, breathing, vocalization and distribution of the load on teeth.

Реконструкция нижней челюсти в Сочи
Anatomy of the mandible ©neoplasty.ru

The mandible is attached to the skull by the condylar process.

The teeth are attached to the lower alveolar process of the mandible.

Inside the mandible, lower alveolar nerve and blood vessels pass through the mandibular canal. The lower alveolar nerve ensures the sensitivity of teeth, gums and skin on the chin.

Mandibulectomy

Mandibulectomy is a surgery in which a part of the mandible is removed.

There are two main types of mandibulectomy: marginal and segmental.

Marginal mandibulectomy is used when cancer has not spread beyond mucous membrane; in this case, it is possible to remove the whole tumour leaving the bone intact.

Восстановление нижней челюсти малоберцовым лоскутом
Marginal mandibulectomy ©e-wiki.org

If the cancer cells affected the bone, they can spread to other parts of the bone. That is why in such cases it is vital to remove the whole segment of the mandible, breaking its integrity. This type of surgery is called segmental mandibulectomy.

In segmental mandibulectomy, the lower alveolar nerve is also removed, so the loss of sensitivity of the skin on the chin and of the lower gum occurs.

97 Segmental Mandibulectomy

Preparation to the surgery

Восстановление нижней челюсти
Computer planning of the surgery ©healthdocbox.com

The surgery is planned on a computer. A plastic surgeon determines how to cut out the flap, how to remove the tumour and how to implant the flap. If a patient is going to get teeth implants, then an orthodontic surgeon specialized in implants joins the surgery.

The removal of the tumour, the reconstruction and implantation are all performed in the process of the same surgery.

Variants of access

There are three variants of access for mandible reconstruction:

Реконструкция нижней челюсти в России
Variants of access for mandible reconstruction ©neoplasty.ru

1. Incision along the chin and along the neck plica is a classical access. It is rarely used and considered to be obsolete.

2. “Invisible” incision within the nuchal fold

3. The access through the mouth, without external incisions, is used for marginal mandibulectomy.

Fibular flap

Fibula bone is a side bone in the leg that does not carry body weight

Реконструкция нижней челюсти малоберцовым лоскутом
Fibular flap ©slideplayer.com

Fibular flap consists of bone, vessels and muscles.

This flap is often used for mandible and maxilla reconstruction and is ideal for further teeth implants.

The removal of the flap does not affect the patient’s quality of life. After the surgery, the patient is able to walk, run and wear high heels.

Phases of the surgery:

1. A plastic surgeon removes the tumour and the adjacent part of the mandible with soft tissues.

2. The surgeon separates a fibular flap for transplantation.

3. The bone taken from donor area will be formed to match the removed part of the mandible precisely.

4. Blood vessels that carry nutrition to the flap will be connected to the circulatory system with the use of microsurgical techniques.

5. The new bone will be attached firmly to the mandible, with screws and plates.

Video evidence

Mandible reconstruction price list

Mandible reconstruction

With a fibular flap taken from the patient’s leg

от 843 000 rub
Your doctor
A leading plastic surgeon specializing in mandibular reconstruction

The surgery is focused on reconstructing the shape and functions of the mandible with the use of patient's own tissues.

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