Cheek-splitting technique for marginal mandibulectomy: A novel approach

When performing marginal mandibulectomy, ensuring complete tumor removal and preventing postoperative iatrogenic mandibular fracture are essential. Pathological fracture can result due to stress concentration at the site requiring acute angle resection. To perform marginal mandibulectomy without making acute angles in patients with a lesion in the molar or more posterior region, a submandibular or transbuccal approach is necessary. Compared to the submandibular approach, the transbuccal approach is considered useful as it reduces operative time and prevents injury to the facial and mental nerves. Additionally, this approach does not leave a scar in the surgical field, which is beneficial in subsequent neck dissection for late neck metastasis. Here, we report 2 cases of lower gingival carcinoma in which satisfactory aesthetic outcomes were achieved with an improved cheek-splitting technique for marginal mandibulectomy using a transbuccal approach, taking into consideration the angle of the mouth, design of the triangular flap, and modiolus. Key words:Mandibular gingival carcinoma, cheek-splitting technique, transbuccal approach, marginal mandibulectomy.