Condylar prostheses in head and neck cancer reconstruction

Objective: To discuss the use of condylar prostheses after mandibular resection for tumor. Design: Case series and literature review. Setting: Tertiary referral center. Patients: Four patients underwent condylar reconstruction with metallic condylar prostheses after hemimandibulectomy for either squamous cell cancer or Ewing sarcoma. Main Outcome Measure: Complications related to the condylar prostheses. Results: Clinical and radiological follow-up in these patients revealed several complications, including exposure or extrusion of the prosthesis and migration of the prosthesis into the epitympanum, resulting in profound sensorineural hearing loss owing to bony destruction of the cochlea. Two of our patients required removal of the mandibular hardware because of the seriousness of the complications, and 1 of the 2 underwent reconstruction of the condyle with a fibular free flap. Conclusions: Metallic condylar prostheses in the setting of tumor resection and reconstruction involve significant risks. Autogenous materials, such as vascularized bone grafts, should be used whenever possible.