Is Jaw in a Day® reconstruction feasible in patients undergoing robotic neck dissection for oral cancer?: a case series with comparative analysis

Abstract

BACKGROUND: Immediate dental implant placement with implant-supported prostheses enables single-stage functional and aesthetic rehabilitation during jaw reconstruction, a technique referred to as "Jaw in a Day®" (JIAD). This study evaluated the feasibility of the JIAD technique combined with retroauricular robot-assisted neck dissection (RA-RAND) in patients with oral cancer undergoing mandibular reconstruction. MATERIALS AND METHODS: We retrospectively reviewed 75 patients who underwent mandibular reconstruction using fibula free flaps from September 2020 to February 2024. Among them, 31 patients were eligible for analysis. Seven patients had retroauricular robot-assisted neck dissection (RA-RAND), and 24 patients had conventional transcervical neck dissection (CTND). Two patients in the RA-RAND group and nine in the CTND group underwent the JIAD procedure. We compared the time from data acquisition to surgery, reconstruction time, total operation time, and length of hospital stay between the groups. RESULTS: No significant differences were observed between the RA-RAND and CTND groups in terms of reconstruction time (median 431 min, IQR 274-442 vs. 310 min, IQR 236-420; p = 0.435) or hospital stay (median 20 days, IQR 17-22 vs. 20 days, IQR 18-33; p = 0.275), although the total operation time was significantly longer in the RA-RAND group (median 831 min, IQR 702-898 vs. 526 min, IQR 444-615; p = 0.002). Within the RA-RAND cohort, there were no significant differences between the JIAD and non-JIAD groups regarding time from data acquisition to surgery (median 17.5 days, IQR 14.2-20.8 vs. 13.0 days, IQR 8.0-24.0; p = 1.000), reconstruction time (median 352.5 min, IQR 311.2-393.8 vs. 431.0 min, IQR 278.0-450.0; p = 0.857), total operation time (median 863.5 min, IQR 847.2-879.8 vs. 701.5 min, IQR 649.0-751.5; p = 0.857), or length of hospital stay (median 18.5 days, IQR 15.2-21.8 vs. 20.0 days, IQR 18.0-22.0; p = 0.762). CONCLUSION: Based on this case series and comparative analysis, the combination of the JIAD technique with RA-RAND appears technically feasible and does not prolong the operative or postoperative course. However, larger studies are required to confirm these findings.