Mandibular reconstruction with reimplantation of the boiled autogenous bone

Reestablishment of mandibular continuity following radical surgery for oral cancer has been a challenging task to the head and neck surgeon. Treated autografts such as autofrozen or irradiated bone have been used for primary reconstruction of the mandible.The first 14 consecutive cases in which a mandibular defect was immediately reconstructed with a boiled autogenous mandible are reviewed. The defect consisted of horizontal ramus alone in 5 cases and symphysis with one or both rami in 9. The resected segment of mandibular bone was dissected free of the gross cancer, shaved and boiled in water for fifteen minutes. The treated bone was replanted with internal fixation, then intraoral and surrounding soft tissue defects were reconstructed with pectoralis major or latissimus dorsi myocutaneous flap. It is essential to the success of this procedure that the boiled autograft is enveoped with the muscle of the myocutaneous flap and all dead space is eliminated. The follow-up period ranged from 2 months to 1 year and 7 months, with a 65% success rate. There has been no tumor recurrence originating in the boiled bone. Radiographic examination of reimplanted bone revealed a gradual absorption process, but in some cases showed evidence of neo-osteogenesis at the contiguous area.Primary reconstruction of mandible with reimplantation of the boiled autogenous bone is distinguished by its ease and is a reasonable alternative in cosmetic and functional restoration.