Reconstruction of a Large Mandibular Defect Utilizing Temporary Zygomatic-Ramal Fixation and Bilateral Risdon Incisions

Christopher A. Derderian, Geoffrey C. Gurtner, Joseph G. McCarthy

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Ameloblastoma is a benign, invasive, odontogenic tumor of the jaws that predominantly affects the mandible. Despite the benign nature of these lesions, there is a high rate of local recurrence after curettage, which usually requires resection. The traditional surgical approach for resection of ameloblastomas, via either mandibulotomy or mandibulectomy, has been through lower lip-splitting incisions, which are associated with significant functional and esthetic sequelae. A case is presented here in which less invasive Risdon and intraoral degloving incisions were used in combination with temporary zygomatic-ramal fixation to maintain occlusion after resection of a large mandibular ameloblastoma. The bilateral Risdon approach provided wide access to the mandible, allowing an angle-to-angle resection to be performed. This approach also provided adequate exposure for an osteocutaneous fibula free flap reconstruction to be performed, with 100% flap survival. At 1 year of follow-up, there were minimal functional and esthetic defects. This approach represents a less invasive alternative that provides access to the mandible for curative resection of benign tumors with minimal postoperative sequelae.

Original languageEnglish (US)
Pages (from-to)16-19
Number of pages4
JournalJournal of Craniofacial Surgery
Issue number1
StatePublished - Jan 2004


  • Ameloblastoma
  • Lip splitting
  • Mandible
  • Reconstruction
  • Surgical flaps

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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