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Rivista Italiana di Chirurgia Maxillo-Facciale 2004 August-December;15(2-3):113-6

language: English

Surgical reconstruction of the osteomucosal defects alveolar crest: a new technique

De Ponte F. S. 1, Santamaria S. 1, Marasco M. 2, Nastro Siniscalchi E. 3

1 U Department of Odontostomatology and Maxillo Facial Surgery, University of Messina, Italy
2 U.O.S. of Maxillo Facial Surgery A.O.U. G. Martino Messina, Italy
3 Private Practice


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The presence of bone defects which remain after oncological surgery of the oral cavity is an important issue when dealing with oncological patients. In the presence of intraoral lesions, the prime objective of excision surgery is not only to remove the lesion with sufficient root margins, but also to re-establish, where possible, function and aesthetics. Various reconstructive techniques are nowadays used, with choice depending on the size of the lesion; the choice also effects the residual defect. For small osteomucosal defects, reconstruction options include local flaps: naso-labial, buccinatory, platysma, hyoglossus flap. For large defects, an equally wide choice includes pedunculate loco-regional flaps, such as sternocleidomastoid muscle, great pectoral muscle, latissimus dorsi flaps, and multi-tissue functional units transposed in a free microvascular variant. Tumours of the alveolar mucus are the third most frequent type of mouth tumours. These require a wide excision of the lesion often followed by a marginal mandibulectomy. This paper presents a case of cancer of the lower alveolar mucous treated with marginal mandibulectomy with reconstruction of the remaining defect using a genioglossus muscle flap. This technique is an innovative method which can be added to the wide range of reconstruction options mentioned in literature. As transposition of tissue from donor sites is not foreseen in such cases, this technique seems to represent an interesting alternative, thanks to ease of use and low morbidity.

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