a

1. Teknik Operasi
Hemimandibulektomi

2. Surgical Landmark of
Mandible
(JohnW.Werning, 2007)

3. VASKULARISASI DAN INERVASI MANDIBULA

4. Jenis Reseksi
Marginal
Resection
Segmental
Resection
Hemimandi-
bulectomy
Total
Mandibulec-
tomy

5. CLASSIFICATION
SYSTEM FOR
MANDIBULAR
DEFECTS1,2
1. Cordeiro PG, Henderson PW, Matros E; Plast Reconstr Surg.; 2018; April; 141(4); 571e-581e. Doi: 10.1097/PRS.0000000000004239
2. Santis GD, Cordeiro PG, Chiarini L, 2019; Atlas of Mandibular and Maxillary Reconstr with the fibula flap, Springer, Switzerland;
doi: 10.1007/978.3.030.10684.3.1; p 1-3
Prosedur
Pembedahan
Desain dari reseksi mandibula
• Menentukan batas reseksi
Insisi (Intra Oral or Extra Oral approach)
Diseksi
• Dimulai dari area bebas sel tumor ke area tumor. Diseksi dilakukan untuk
membebaskan perlekatan otot masseter, pterigoid medial hingga terlihat
ramus mandibula
• Identifikasi foramen mentale dan di preservasi
• Pembuluh darah di ligasi
Osteotomi rahang bawah
• Pemotongan tulang dengan saw
Pengangkatan massa tumor
• Disarticulation for Hemimandibulectomy
Rekonstruksi dan suturing
• Insisi intra oral menyusuri tulang dari regio posterior sampai anterior
Hupp J, Ellis E, Tucker MR. Contemporary Oral and Maxillofacial Surgery 7th Edition 2019.

6. Garis insisi Intra oral

7. Reconstruction of Mandible
Plate
Reconstrutions
• Plate
reconstruction
only
• TMJ Prostheses
Immediate
Nonvascularized
• Costae
• Iliac crest
• Bioengineering
Material
Immediate
Vascularized
• Fibula free flap
• Iliac crest free
flap
1. Melville JC, et al; Mandibular defect Reconstruction using bioengineering; J. Oral Maxillofac Surg; 2020; 78:661.e1-661.e29
2. Melville JC, et al:; Regenerative strategies for maxillary and mandibular ten construction; Springer Nature; Switzerland, 2019;
Doi: 10.1007/978-3-319-93668-0_14

8. Risk and Complication
Oedem
Soft tissue Laceration
Infection
Wound dehiscence
Plate / Bone exposure
Malocclusion of contralateral side

9. Thank You