Outcome analysis of condylar prosthesis in large head and neck neoplasm reconstruction

Reconstruction of the condyle after an ablative procedure for mouth neoplasms remains a surgical challenge because these patients with advanced cancer involving the condyle are subjected to massive ablative surgery, and subsequent major reconstruction with free flap and/or reconstruction prosthesis, the prognosis being poor. Therefore, reports of condylar prosthesis in head and neck cancer reconstruction are rare and with mixed results. This report is for the review of the literature and case series study of the condylar prosthesis. As with virtual technique improvement nowadays, an innovation CAD CAM technique is applied for the treatment plan for these patients. We analyze a serial case of advanced oral neoplasms who receives tumor ablation, i.e., mandibulectomy and disarticular resection, and gains symmetrical mandibular architecture after reconstruction with plate and condylar prosthesis. There is still high complication rate (41.7%) noted, namely condylar prosthesis displacement (two cases), impinge on external ear canal (two cases), and erosion of cranial base (one case). The reasons are attributed to massive flap burden, scar contraction, poor dental articulation, and possible technique error during the operation. According to the outcome analysis, virtual technique including with reconstruction plate and condylar prosthesis in conjunction with flap reconstruction are feasible treatment modality for this serial case of advanced oral neoplasms.