An approach to marginal mandibulectomy and reconstruction for lower gingival carcinoma: A case report

• Published in: Oral and maxillofacial surgery cases 2020-09, Vol.6 (3), p.100172, Article 100172
• Main Authors: Shibata, Akio, Kawahara, Kou, Oguri, Takashi, Ohira, Memi, Oriyama, Tasuku, Niwa, Akihiro
• Format: Article
• Language: English
• Subjects: Buccal fat pad; Cheek-splitting incision; Intraoral surgical defect; Marginal mandibulectomy; Polyglycolic acid sheet
• ISSN: 2214-5419; 2214-5419
• DOI: 10.1016/j.omsc.2020.100172

The patients with early stage, clinically node-negative oral squamous cell carcinomas are usually treated with oral surgical excision of primary tumor. Marginal mandibulectomy of posterior mandible is difficult with an adequate safety margin via an intraoral. The cheek-splitting incision allows marginal resection at the posterior mandible under direct vision and it can avoid invasion to the neck region. The Buccal fat pad flap (BFP) grafting is considered feasible for the reconstruction of surgically induced defects, because of it has a high success rate due to BFP's rich vascularity, proximity to the recipient site, low donor-site morbidity, and simple surgical procedure for grafting. The combination of BFP and The mucosal defect covered with fibrin glue and polyglycolic acid sheet (MCFP technique) can makes early intake after surgery, excellent wound-healing and pain-relieving effects. We reported a case of squamous cell carcinoma arising at the posterior mandibular gingiva that was treated by marginal mandibulectomy via a cheek-splitting transbuccal approach, reconstructed the defect after surgery using a BFP covered with MCFP technique. A major advantage of this approach is that it obtains an adequate margin of the posterior site without requiring a cervical incision thus allowing early intake after surgery and excellent wound-healing and pain-relieving effects. •The cheek-splitting incision allows marginal resection at the posterior mandible under direct vision and it can avoid invasion to the cervix.•The combination of BFP and MCFP technique can makes early intake after surgery, excellent wound-healing and pain-relieving effects.•Cheek-splitting transbuccal approach and reconstructed using a buccal fat pad covered with MCFP technique are options for the treatment of c squamous cell carcinoma arising at the posterior mandibular gingiva.