Shadowgraphs of Montreal

BÉLA EGYEDI was born in Hungary and is now a Canadian citizen. His art work has appeared in The Antigonish Review, Fiddlehead, The West Coast Review, The Canadian Forum, and elsewhere. He is a former OR contributor

Marginal Mandibulectomy for Lower Gingival Carcinoma With a Cheek-Splitting Transbuccal Approach and Reconstruction by Buccal Fat Pad Flap: A Case Report

In cases of malignant tumor at the posterior region of the mandibular gingiva, a submandibular approach is usually chosen for secure resection of the lesion. This technique allows a good view of the surgical site and makes the operative procedure relatively easy. However, this approach is more surgically invasive and increases the operating time. On the other hand, it is difficult to resect the tumor with sufficient safety margin via an intraoral approach.We present a case of squamous cell carcinoma arising at the posterior mandibular gingiva that was completely resected via a cheek-splitting transbucal approach. Subsequently, the bucal fat pad flap was used to reconstruct the defect. The patient has been followed up for one year, and no recurrence has been observed. Moreover, there was only a very faint scar at the cheek and few instances of trismus.This technique should be added to the useful approaches for resection of the posterior mandibular tumor, because the resection is possible under direct vision with only slight side effects