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Morbidity related to the lip-split mandibulotomy approach: a systematic and narrative review.
Hedayat, Fatemeh; Jerry Htwe, Ko Ko; Vassiliou, Leandros-Vassilios; Kyzas, Panayiotis.
Afiliación
  • Hedayat F; School of Medicine, University of Central Lancashire, Preston, United Kingdom.
  • Jerry Htwe KK; School of Medicine, University of Central Lancashire, Preston, United Kingdom.
  • Vassiliou LV; School of Medicine, University of Central Lancashire, Preston, United Kingdom; Department of Oral and Maxillofacial Surgery, East Lancashire Hospitals NHS Trust, Blackburn, United Kingdom.
  • Kyzas P; School of Medicine, University of Central Lancashire, Preston, United Kingdom; Department of Oral and Maxillofacial Surgery, East Lancashire Hospitals NHS Trust, Blackburn, United Kingdom. Electronic address: kyzasp@icloud.com.
Br J Oral Maxillofac Surg ; 60(4): 430-436, 2022 05.
Article en En | MEDLINE | ID: mdl-35184915
The lip-split mandibulotomy (LSMA) is an access procedure that has been used in head and neck (H&N) surgery as an aid to surgical resection of inaccessible tumours of the postertior oral cavity and oropharynx. Anecdotal evidence suggests that it has significant morbidity. Voices of concern within the H&N surgical community suggest that it has been abandoned in favour of technological advances such as robotic surgery. We report here the first (to our knowledge) registered systematic review of its kind, documenting the safety and efficiency of LSMA in H&N surgery. We performed a PRISMA-guided systematic review (PROSPERO-registered) and identified reports using a search algorithm in MEDLINE/EMBASE. LSMA-related surgical complications were recorded using the Clavien-Dindo classification. Secondary outcomes included swallowing dysfunction, facial cosmesis, and patient satisfaction recorded in health-related quality of life questionnaires (HRQoL). From 125 studies identified, 54 met the inclusion criteria (3872 patients). The LSMA mortality rate was 0%; we did not identify a single case of perioperative death. The median rate of osteoradionecrosis was 5.4%, whereas fistula formation was 5.7%. Malunion was noted in 4.9%. Other complications (surgical site infection, plate exposure) were around 5%. There was significant between-study variation with regards to swallowing assessment tools, but overall there was no significant difference in outcomes. This was also the case for the HRQoL questionairres. LSMA is a safe procedure with an acceptable rate of complications, and should definitely remain in the armamentarium of H&N surgery.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Orofaríngeas / Procedimientos Quirúrgicos Robotizados Tipo de estudio: Prognostic_studies / Qualitative_research / Systematic_reviews Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Br J Oral Maxillofac Surg Año: 2022 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Orofaríngeas / Procedimientos Quirúrgicos Robotizados Tipo de estudio: Prognostic_studies / Qualitative_research / Systematic_reviews Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Br J Oral Maxillofac Surg Año: 2022 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido