The mandible or the bone of the jaw, not only defines the face but is also essential for speech and chewing of food. It is a U-shaped bone that has two bony extensions called ramus. The teeth are attached to the upper part of the mandible with the help of the periodontal membrane and the lower part of the mandible comprises thick layers that contain porous spongy bone tissue in between them.
If a cancerous lesion is detected in the floor of the jaw or mandible, then the surgery that is performed to remove the cancerous tissue and its surrounding tissue, is termed as mandibular resection surgery. The extent of surgical removal of tissue depends on the extent of spread of cancerous cells in the region. Depending on the extent of affected tissue, resection surgery of the jaw is of two types: partial thickness resection and full thickness resection.
Diagnosis of Mandibular Cancer
There can be several causes of jaw cancer but proper and in-time diagnosis can always save lives. Let us have an understanding of the diagnostic procedure used to detect cancer of the jaw. The first step in the diagnostic procedure is to conduct an X-ray of the affected region. During normal checkup, if the doctor suspects the presence of cancerous cells, he might recommend an X-ray or a CT scan. If the scans of the jaw show some abnormalities, the doctor then removes some amount of tissue from the jaws of the patient and observes the same under a microscope. This procedure, termed as biopsy, is carried out under local anesthesia.
Mandibular resection is recommended when the cancer has spread to the jawbone or mandible, and involves partial or complete removal of the jaw. A partial thickness resection is conducted when the doctor feels that there is a risk of the cancer spreading to the jawbone, although there is no indication on the X-ray plate. Partial thickness resection involves removal of the upper thin layer of the jawbone that contains the teeth. Full thickness resection, however, involves the removal of the entire jawbone and is carried out only if there is evidence on the X-ray plate of the cancer having spread to the jawbone.
Mandibular resection surgery usually requires around 2 weeks stay in the hospital. During the surgery, tumor is removed along with the teeth and affected tissue surrounding the tumor. If the tumor has spread to a large portion of the jawbone, then the entire jawbone is removed and a metal plate is implanted to provide support to the jaw and to retain the structure of the mouth. Post operative care involves special sessions from speech therapists and physiotherapists who help bring the patient's speaking ability back to normal.
Also, the doctor recommends a diet that comprises mostly liquid food, for a few days after the operation. For the first two weeks or so, post surgery, the patient is fed through a naso-gastric tube and is not allowed to eat or drink anything during this period. In case the infection builds up in the oral cavity, the patient is prescribed antibiotics. Also, analgesics or painkillers are administered to help the patient cope up with the constant pain.
Although mandibular resection surgery is relatively safe, certain complications might arise in rare cases. Fracture of the jawbone is one of the common complications. If the patient receives radiation therapy post the operation, then there is a risk that he might develop osteoradionecrosis or death of bone tissue on exposure to radiation. To prevent osteoradionecrosis, it is important to ensure that the facial artery is preserved and functions properly even after the surgery. This will assure proper flow of blood to the facial tissue, including muscles and bones and prevent them from decaying. One of the rare complications is the spontaneous generation of bone tissue, known as ameloblastoma.
Thus, we see that mandibular resection surgery can be safe and effective if proper care is taken to prevent the possible complications and risks. In the U.S., this surgery can cost anything between $20,000 to $30,000. Recovery time varies among individuals, as it depends on the ability of a body to heal quickly. However, it is a must to consult a doctor before going ahead with any kind of medical procedure, including surgeries.