Cancer involving lower jaw bone(mandible) is a common scenario in oral cancer. Cancer can arise from cheek (buccal mucosa) and involve jaw bone or cancer can arise denovo on jaw bone.
1. ulcer or growth involving jaw bone
2. Swelling of jaw bone
3. Loosening of tooth
4. Change in voice or hoarseness
5. Lumps in neck
1. Biopsy
2. CT scan/PETCT scan for staging .
Surgery is main treatment option called Composite resection followed by post operative radiotheraphy.
Here only a margin of mandible is resected maintaining the continuity of jawbone so that shape and function (chewing , speech) are preserved. The resected area is generally covered with flap.
This type of surgery is done in cases with cancer touching jaw bone or early involvement of jaw bone.
marginal mandibulectomy
marginal mandibulectomy
Here bone is involved by tumor, so full thickness segment of jawbone is removed to clear tumor.
This causes significant morbidity to functions like chewing , speech, swallowing and change in external appearance.
To reduce this morbidity during cancer surgery reconstruction can be done using bone or soft tissue flaps after resection of cancer.
Bone can be replaced with bone using leg bone call Fibula free flap.
This restores continuity of bone , so all functions are preserved and enhances external appearance.
Cancer of lower jaw bone
Resected jaw bone with cancer.This defect will be reconstructed with fibula free flap.
Fibula bone in leg will be shaped according to removed jawbone and fixed to jawbone
Fibula bone in leg will be shaped according to removed jawbone and fixed to jaw bone. Skin of leg harvested along with bone will cover the defect in the mouth. Blood vessels of bone are connected to neck vessels for new blood supply.
After bone flap usage for reconstruction shape of face is restored ,occlusion of teeth is maintained so chewing hard food is possible and speech and swallowing are not affected.
Cancer of jaw bone , underwent composite resection and reconstruction with fibula free flap
Pre Planting &IMF
Resection
Harvesting fibula free flap
Harvesting fibula free flap
Harvesting fibula free flap
Osteotomy
Osteotomy,Contouring&Anastomosis
Post operative picture .Restored function and cosmesis
After completion of treatment patients can have fixed teeth on implants.
Another example of jaw bone reconstruction
-Oral cancer involving mandible (jaw bone)is a common scenario. This requires multimodality treatment and team approach for both resection and reconstruction to cure the patient from disease and also to restore form and function so patients quality of life is not affected.
-Contact us, DR Rahul buggaveeti and his team Dr Umanath Nayak , Dr Abhishek Bhudarapu , the best head and neck surgeon team in south India for superior oncological results.