On March 21st, The writer learned from Hainan Cancer Hospital that the head and neck specialist in the hospital successfully performed a high-risk oral and maxillofacial tumor resection and reconstruction surgery, helping Ms. Liu restore her appearance and relieve her pain.
01
A woman has a tumor growing inside her mandible
Three years ago, Ms. Liu noticed a slight swelling on her chin, but since it didnt hurt or itch, she didnt pay much attention to it. Gradually, her chin grew larger and larger, and the pain worsened. Her distorted appearance and intensified pain caused her great suffering.
In order to determine the cause of her condition, Ms. Liu came to the Head and Neck Surgery Department of a Hainan Cancer Hospital for medical consultation.
Based on relevant examination, Dr. Qian Yong, Director of the Head and Neck Surgery Department, considered that the mass was most likely an "ameloblastoma". Qian Yong explained that ameloblastomas are mostly benign tumors of the jawbone. However, as they grow larger, they gradually invade and destroy the surrounding bone and soft tissues, necessitating prompt surgical removal.
"Ms. Lius tumor has a diameter of 10 centimeters, and there is extensive destruction of the mandible (lower jaw). In order to completely remove the tumor and prevent recurrence, it is necessary to remove the affected portion of the mandible along with it." Qian Yong said.
Considering Ms. Lius relatively young age, after surgery, the extensive defect in the lower jaw may significantly affect her facial aesthetics and oral function. Surgery is only successful if the surgical defect area is reconstructed and repaired in situ.
Qian Yong and his team have thoroughly discussed and comprehensively analyzed the patients condition and overall health. After careful consideration, they have devised a surgical plan that aims to achieve the best outcome for Ms. Liu. This plan involves not only the removal of the tumor but also the precise reconstruction of the mandible, creating an opportunity for future dental implantation.
Qian Yong (right) performs surgery on the patient (file photo)
02
Experts skillfully use leg bones to reconstruct the "chin"
Currently, the "optimal material" for mandibular repair is autogenous fibula. As Qian Yong explained, the fibula is a pair of long bones located on the lateral side of the lower leg. It is a non-weight-bearing bone. After bone harvesting, as long as there is no vigorous exercise, it will not have an impact on daily activities.
Everything is ready, and the surgery was proceeded as scheduled. After successfully removing the tumor, Qian Yong used the technique of vascularized fibula grafting. He took a segment of fibula from Mrs. Lius left leg, approximately 15 centimeters in length. While preserving the periosteum and blood vessels, he then fractured the fibula into three segments and reconstructed it into the shape of a horseshoe for the mandible. After securing it with titanium plates, the reconstructed fibula was connected to the remaining chin segment. This surgical procedure was a true test of the surgeons skill. Qian Yong explains, "Facial reconstruction requires precise matching and seamless integration. Even a slight error can affect the facial appearance and bite function."
After the "new chin" is attached, in order to ensure the survival of the transplanted bone, Qian Yong meticulously uses sutures as fine as hair under a microscope to precisely connect the arteries and veins of the fibular skin flap with those of the neck, reconstructing the blood circulation system.
In the end, this highly complex oral and maxillofacial tumor resection and reconstructive surgery was successfully completed. During the three-month postoperative follow-up, Mrs. Lius facial appearance has largely returned to normal. She plans to undergo dental implantation at a later date, and her speech and chewing functions will gradually recover to normal.
Comparison images before and after the surgery
Expert recommendations
Qian Yong reminds that when symptoms such as facial swelling, lower jaw protrusion, facial asymmetry, or continuous occurrence of loose teeth, discomfort, and pain are present, it is important to seek timely medical screening to avoid delaying the optimal treatment opportunity.
Introduction of the expert
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