The use of condylar prostheses in head and neck reconstruction

Abstract

The replacement and reconstruction of the mandibular condyle following mandibular resection can be achieved with condylar replacement surgery. The aim of this study was to evaluate the clinical outcome of head and neck patients who underwent placement of condylar prostheses as part of their mandibular reconstructive surgery. We retrospectively reviewed 34 head and neck patients who had placement of condylar prostheses between January 01, 2009 to March 01, 2024. The measured outcomes included: patients’ occlusion, facial nerve function and data regarding return to theatres for further surgeries. We identified a total of 35 condylar replacement cases as part of mandibular reconstruction. 18 cases (51.4 %) were for malignant pathology, 17 (48.6 %) were for benign pathology.11 patients (32.4 %) received preoperative radiotherapy. 15 patients (44.1 %) underwent postoperative radiotherapy. 5 cases (14.3 %) required return to theatre post-surgery for partial removal of platework including the condylar component. Satisfactory occlusion was achieved in 25 cases (71.4 %). There were 7 patients with long term (20.6 %) unilateral facial paralysis. 4 patients (11.8 %) developed facial paralysis immediately postoperatively, and 3 patients (8.8 %) had delayed onsets. In 1 patient, the condylar prosthesis eroded through the glenoid fossa but remains asymptomatic. Consideration should be made into investigating a larger patient series, particularly comparing patients who had a condylar prosthesis and those that did not.