Current indications of mandibular condyle plate osteosynthesis: two cases reports

Abstract

Introduction: Certain benign or malignant pathologies may require a mandibulectomy with resection of the condyle. The gold standard for this type of reconstruction is the microanastomosed fibular free flap. An immediate reconstruction technique using an osteosynthesis plate with condyle can be proposed. The aim of this article is to evaluate the indications and describe the complications of osteosynthesis plates with condyle, through the presentation of two clinical cases. Observation: Two patients were treated by radical hemi-mandibulectomy, with cervical curage, placement of an osteosynthesis plate with condyle, and coverage with flap of pectoralis major. Then they received radiation therapy with or without chemotherapy. No cases of erosion of the glenoid fossa or tympanal bone were found. Comments: Condyle osteosynthesis plates are an interesting alternative when a fibular flap cannot be performed for local (arteriopathy), carcinologic (poor prognosis), or general and anesthesic reasons. A tissue preservation protocol, with conformation and coverage of the plate must be undertaken to limit the risk of complications (infections, exposure and fracture of the plate, temporal bone erosion, heterotopic bone formations). Conclusion: Condyle osteosynthesis plates restore aesthetic and function immediately, temporarily or even permanently. Clinical and radiological follow-up must be established following this type of reconstruction.