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Arnold Komisar, MD, DDS; Steven Warman, MD; Eliot Danziger, MD

Arch Otolaryngol Head Neck Surg. 1989;115(7):830-833.

Abstract
• Eleven patients who underwent mandibular reconstruction with A-O plates were followed up for as long as 40 months. The patients underwent either immediate or delayed mandibular reconstruction. Nine patients had free cortical bone grafts included in the reconstruction. Complications in patients who underwent immediate reconstruction included loss of the bone graft due to infection, external and intraoral exposure of the reconstruction plate, pain, and infection. In the patients with immediate reconstruction, more than 50% of the bone grafts resorbed. There were less complications and minimal bone graft resorption in patients who underwent delayed reconstruction. The cosmetic results were initially good in both immediate and delayed reconstruction but deteriorated as more surgery was required for management of complications. At 40 months, 7 of 11 patients (5 of 9 with immediate reconstruction) had died of local recurrence, distant metastasis, or another primary tumor. No patients were rehabilitated prosthetically. We conclude that while A-O plating is technically easy and has a low perioperative morbidity rate, the long-term morbidity rate is high. This must be weighed against the benefits of the procedure and the probability that the patients will have a poor functional outcome.

(Arch Otolaryngol Head Neck Surg. 1989;115:830-833)

Author Affiliations
From the Department of Otolaryngology, Albert Einstein College of Medicine, Albert Einstein Affiliated Hospitals, Bronx, NY.

Footnotes
Accepted for publication January 13, 1989.

Read before the American Academy of Facial Plastic and Reconstructive Surgery, Palm Beach, Fla, May 8, 1988.

Reprint requests to 1317 Third Ave, New York, NY 10021 (Dr Komisar).

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