Tunneling of facial approaches for resection and reconstruction of benign mandibular lesions - a report of two cases

Sep 29, 2026

Uploaded by Jake

Mandibular reconstruction relies on surgical options that often require extensive face and neck incisions for visualization and for resection and reconstruction of large defects. Such approaches can lead to greater aesthetic compromise and higher risk of neurovascular injury. This report presents two cases using tunneled dissection facial approaches to enable resection and reconstruction of extensive mandibular defects involving the body, ramus, and temporomandibular joint, aiming for improved access with reduced morbidity.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

I. Introduction

Overview of mandibular lesions and treatment goals

Facial approaches for temporomandibular joint access

Anatomical considerations for mandibular resections

CASE REPORT [https://doi.org/10.5125/jkaoms.2025.51.6.410](https://doi.org/10.5125/jkaoms.2025.51.6.410)[ ](https://doi.org/10.5125/jkaoms.2025.51.6.410)pISSN 2234-7550 · eISSN 2234-5930 Tunneling of facial approaches for resection and reconstruction of benign mandibular lesions: a report of two cases Pedro Tapia1,2,3 , Christopher Reyes1 , Jessica Zeballos1 , Micaela Schälchli4 , Benjamín Ossandón-Zúñiga5 , María-José Flores6 , Camilo Barrientos7 , Enrique Steffens8 1Department of Oral and Maxillofacial Surgery, Regional Hospital Dr. Franco Ravera Zunino, Rancagua, 2Department of Oral and Maxillofacial Surgery, Clínica RedSalud Vitacura, 3Department of Oral and Maxillofacial Surgery, Universidad del Desarrollo, 4Faculty of Medicine, Universidad del Desarrollo, 5Faculty of Medicine, Universidad de Chile, Santiago, 6Faculty of Medicine, Universidad AndrésBello, Viña del Mar, 7Oral and Maxillofacial Surgery and Traumatology Specialty Program, Universidad del Desarrollo, 8Oral and Maxillofacial Surgery and Traumatology Specialty Program, Universidad Andrés Bello, Santiago, Chile Abstract (J Korean Assoc Oral Maxillofac Surg 2025;51:410-416) In the field of mandibular reconstruction, multiple treatment options and surgical approaches are available. Most techniques require extensive incisions across the face and neck to visualize, resect and reconstruct large mandibular defects. These approaches are associated with greater aesthetic compromise and an increased risk of injury to neurovascular structures. The aim of the present study is to introduce alternative facial approaches using tunneled dissection techniques, which allow for the resection and reconstruction of extensive mandibular defects involving the body, ramus, and temporomandibular joint. Key words: Mandibular reconstruction, Odontogenic tumors, Surgery, Oral [paper submitted 2025. 8. 22 / revised 1st 2025. 10. 18, 2nd 2025. 10. 30, 3rd 2025. 11. 18 / accepted 2025. 11. 28] I. Introduction A wide variety of tumorous and cystic lesions affect the mandibular region, with behaviors ranging from non-aggressive benign forms to destructive lesions. It has been reported that odontogenic tumors occur more frequently in the mandible than in the maxilla1,2 . In general terms, within the group of odontogenic tumors, benign lesions are more prevalent than malignant ones, accounting for 94 . 1% versus 5 .9%, respectively2. The most common benign odontogenic lesions are ameloblastomas (51.2%) and keratocysts (39.4%) reported in a systematic review1. Among benign non-odontogenic tumors, Micaela Schälchli Faculty of Medicine, Universidad del Desarrollo, Av. Plaza 680, Las Condes, Santiago 7610658, Chile TEL: +56-9-34083392 [E-mail: micaela.schalchli@gmail.com](E-mail: micaela.schalchli@gmail.com) ORCID: [https://orcid.org/0009-0004-3707-780X](https://orcid.org/0009-0004-3707-780X) CC This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([http://creativecommons.org/](http://creativecommons.org/)[ ](http://creativecommons.org/)[licenses/by-nc/4.0/](licenses/by-nc/4.0/)), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2025 The Korean Association of Oral and Maxillofacial Surgeons. the central giant cell granuloma stands out, representing 7% of benign mandibular tumors and most frequently located in the anterior region of the mandible3. Regarding malignant odontogenic tumors, 74.3% are located in the mandible, with ameloblastic carcinoma being the most frequent subtype, representing 25 .7%4. Given the aggressive behavior and high recurrence rate of certain mandibular lesions, their management often requires wide surgical resection. These interventions demand surgical approaches that ensure adequate visualization, anatomical control, and access to the affected mandibular segments. The choice o

FAQs

What problem do traditional mandibular reconstruction approaches present?

Most require large incisions across the face and neck, which can worsen aesthetics and increase the risk of injury to neurovascular structures.

What is the main aim of this two-case report?

To introduce alternative facial approaches using tunneled dissection techniques for resection and reconstruction of extensive benign mandibular defects.

Which mandibular regions can be addressed with the tunneled dissection approach described here?

The report focuses on defects involving the mandibular body, ramus, and the temporomandibular joint.

Sep 29, 2026

Uploaded by Jake