The mangled mandible or lower jaw of a 45-year-old cancer patient was reconstructed using Fibula-long bone in his leg. The process was highly challenging and the man had just recovered from COVID-19.
Since massive cancerous tumour had penetrated the jawbone, it had to be removed, resulting in loss of ability to speak or swallow besides causing disfigurement. Doctors took CT scan of the lower jaw, used 3D mapping to take measurements of the part, and reshaped fibula into mandible. This procedure helped the patient retain the ability to speak and swallow.
While titanium plates could have been used to replace the jaw bone, Umanath Nayak, senior consultant head and neck surgical oncologist said that when radiation is offered as part of the caner treatment, the titanium plates react to it. “Since fibula is taken from his body, there will be no such reactions. Besides, dentures or teeth can be replaced on the fibula which is not possible on the plates,” Dr Umanath said.
The city resident had extensive cancerous growth on the floor of his mouth and a badly mangled mandible. He consulted doctors at Apollo Cancer Institute on July 24. He was suffering for three months and delayed treatment due to COVID-19 outbreak. The patient was found to be COVID-positive two weeks prior to consulting doctors. He was re-tested after a week, was found to be negative and a surgery was planned.
The surgery involved removal of the extensively spread cancer in the floor of the mouth along with the central segment of the mandible. To mitigate the functional disruption of the jaw and reduce disfigurement, the team of specialists headed by Dr Umanath, and aided by reconstructive surgeon B. Rahul, performed a mandible reconstruction surgery with a vascularised segment of bone harvested from the fibula, using specialised computer software and 3-D virtual planning, on August 3.
The procedure lasted around 10 hours. The patient has been discharged.