Mandibulectomy

Mandibulectomy is a complex surgery that removes part or all of the lower jaw bone. This is called the mandible. It’s done to treat issues like oral cancer, tumors, or severe facial trauma.

Having a mandibulectomy can change your life. It fixes the medical problem and affects how you look, speak, and eat. In this article, we’ll explore why you might need this surgery, the types of procedures, and what happens during and after.

What is a Mandibulectomy?

A mandibulectomy, also known as a mandible resection, is a surgery to remove part or all of the mandible, the lower jaw bone. It’s done to treat jaw issues like cancer, severe fractures, or osteonecrosis.

The mandible is key for speaking, chewing, and keeping the face’s shape. It’s the biggest and strongest bone in the face. It has a curved, horizontal part and two vertical parts that go up to form the ramus on each side.

A mandibulectomy can be partial or total. A partial one removes just a part of the jaw. A total one removes the whole jaw.

The main reason for a mandibulectomy is cancer in the jaw. These cancers can start in the mouth or spread from other places. Removing the jaw bone helps stop cancer from spreading and improves the patient’s chances of recovery.

Other reasons for this surgery include benign tumors, severe fractures, and osteonecrosis. This can happen due to radiation or certain medicines.

Doctors decide on a mandibulectomy after talking with a team of experts. They look at the tumor’s size and location, if it has spread, and the patient’s overall health.

Reasons for Undergoing a Mandibulectomy

A mandibulectomy is a surgery that removes part or all of the jawbone. It’s done for several reasons. These include oral cancer, benign jaw tumors, and severe facial trauma.

Oral Cancer

Oral cancer is a common reason for this surgery. When jawbone cancer is found, removing the affected part is often needed. This stops the cancer from spreading and helps rebuild the jaw.

Benign Tumors of the Jaw

Benign jaw tumors are not cancerous but can cause problems. They can weaken the jaw and lead to fractures or deformities. Sometimes, a mandibular osteotomy is done to remove the tumor and prevent further damage.

Severe Facial Trauma

Severe facial trauma, like from a car accident, can damage the jawbone. In bad cases, a mandibulectomy is needed. It removes damaged bone to help heal and rebuild the jaw. This surgery aims to restore function and appearance.

Types of Mandibulectomy Procedures

Mandibulectomy procedures can be divided into two main types: partial and total mandibulectomy. The choice of procedure depends on the tumor’s size and location, and the patient’s overall health.

Partial Mandibulectomy

A partial mandibulectomy removes only a part of the lower jaw bone. It’s often chosen when the tumor is in a specific jaw area. This method helps keep more jaw function and appearance compared to a total mandibulectomy.

The surgeon carefully removes the affected jaw part while keeping the rest stable. Sometimes, reconstructive surgery is done at the same time or later to fix the jaw’s look and function.

Total Mandibulectomy

A total mandibulectomy removes the whole lower jaw bone. It’s needed when the tumor spreads across the jaw or a partial mandibulectomy won’t work.

In this procedure, the surgeon takes out the entire jaw and might remove nearby tissues like lymph nodes. Because the jaw is completely removed, reconstructive surgery is needed to fix the jaw’s look and function. This can involve bone grafts, metal plates, or other techniques.

The surgical team decides between partial and total mandibulectomy based on the patient’s condition and the tumor’s extent. The goal is to remove the diseased tissue while keeping healthy tissue and ensuring the best outcome.

Preparing for Mandibulectomy Surgery

Getting ready for a mandibulectomy is key to a good outcome. This surgery is often needed for jaw problems or cancer. Before the surgery, patients have many meetings and tests to check their health.

The surgical team looks at the patient’s health history and does physical checks. They also order X-rays, CT scans, or MRIs. These steps help the surgeons plan the surgery and spot any possible problems.

Before surgery, patients might need to make some changes. These can include:

• Quitting smoking, as it can slow healing and raise risks
• Changing medications, like blood thinners or supplements, that could affect surgery
• Keeping teeth clean to lower infection risk
• Following a special diet for better nutrition and recovery

For some, the surgery is part of a bigger cancer treatment. They might need radiation or chemotherapy first. The healthcare team will help plan these treatments and guide preparation for the surgery.

By following all instructions and working with their surgeons, patients can get the best results from their surgery. This helps them recover smoothly.

The Mandibulectomy Surgical Procedure

A mandibulectomy, or jaw removal surgery, is a complex procedure. It needs careful planning and a skilled team. The surgery removes the affected jaw part and rebuilds it for function and appearance.

Anesthesia and Incisions

The procedure starts with general anesthesia to keep the patient comfortable. The surgeon then makes incisions in the skin and soft tissues around the jaw. This allows access to the bone underneath.

Removing the Affected Portion of the Jaw

The surgeon uses special tools to remove the diseased jaw part. The amount removed depends on the size and location of the affected area. This is decided based on imaging and biopsy results.

Reconstructing the Jaw

After removing the jaw part, the surgeon starts rebuilding the jaw. This step may involve bone grafts from the patient’s body or donor tissue.

Reconstructive surgery might also include dental implants. These support prosthetic teeth, helping with chewing and speaking. The techniques used depend on the surgery type and the patient’s needs.

Recovery and Rehabilitation After Mandibulectomy

After a mandibulectomy, the road to recovery is key. It helps you get back to normal and adjust to any looks changes. You’ll team up with your healthcare crew, like surgeons and nutritionists, to make sure you heal well. This is a big deal for your facial reconstructive procedure.

Pain Management

Managing pain is a big part of getting better after a mandibulectomy. Your doctor will give you the right meds and tell you how to handle pain. You might also use cold packs and relax to feel better. These steps help with the reconstructive surgery recovery.

Dietary Adjustments

Changing your diet is important after a mandibulectomy. You’ll need to eat differently because of how you chew and swallow. A nutritionist will help you make a meal plan that’s just right for you.

Speech and Swallowing Therapy

Some people might have trouble speaking and swallowing after a mandibulectomy. A speech therapist will check on this and create a plan to help. You’ll learn exercises and techniques in therapy. They’re key for a good recovery from this facial reconstructive procedure.

Reconstructive Options Following Mandibulectomy

After a mandibulectomy, patients have many reconstructive surgery choices. These options help restore the jaw’s look and function. The right technique depends on how much of the jaw was removed, the patient’s health, and what they want to achieve. Facial reconstructive procedures use the patient’s own tissue or prosthetics to rebuild the jaw.

Bone grafting is a common choice. It involves taking bone from another part of the body, like the hip or leg, to rebuild the jaw. This method helps restore the jaw’s structure and strength. It also allows for better function and appearance. Sometimes, bone grafts are used with dental implants to replace missing teeth and enhance the patient’s life quality.

Prosthetic devices are another option. These are custom-made to replace missing jaw and teeth parts. They improve appearance and help with speaking and eating. These devices are a non-surgical choice for those not suited for bone grafting or dental implants.

The success of reconstructive surgery after a mandibulectomy depends on several things. These include the patient’s health, the quality and amount of tissue for reconstruction, and the surgical team’s skill. Patients should talk to their healthcare providers to find the best option for their needs and goals.

Potential Risks and Complications of Mandibulectomy

Mandibulectomy, like any surgery, comes with risks and complications. It’s key for patients to know these risks and talk about them with their surgical team. This way, they can prepare better for the recovery.

Infection

Infection is a common risk with mandibulectomy. The mouth has many bacteria, and the surgical area might get infected. Doctors usually give antibiotics to prevent or treat infections. Keeping good oral hygiene and following care instructions can help avoid infection.

Nerve Damage

The mandible has nerves that control face, tongue, and lip movements. During mandibulectomy, these nerves might get hurt. This can cause numbness, tingling, or weakness. The team tries to avoid nerve damage but can’t always succeed.

Difficulty with Speech and Swallowing

After mandibulectomy, patients might find it hard to speak and swallow. How hard it is depends on the surgery. Some might need speech and swallowing therapy. Working with a speech therapist and dietitian can help improve life after surgery.