Novel surgery removes rare tumor, rebuilds face and jaw

September 7, 2012

Using a novel surgical approach, it's possible to rebuild a functional lower jaw and mouth, and preserve a patient's ability to eat and speak after removing an invasive facial tumor, according to a new report from Henry Ford Hospital in Detroit.

This not only documents a successful surgical technique to create a fully functional lower jaw, but also reports the rare occurrence of a (osteosarcoma) that spread from the patient's right femur to his jaw .

Most commonly, osteosarcoma is found in the long bones of the leg and does not spread to other parts of the body.

"The involved nearly all of his jaw bone, lower lip, chin, neck skin, tongue and both cheeks, approximately the lower third of the face and upper half of his neck," says senior study author Tamer A. Ghanem, M.D., Ph.D., director of the Head and Neck & Microvascular Surgery Division and division head of the Department of Otolaryngology-Head and Neck Surgery at Henry Ford Hospital.

"We had to think outside the box to not only safely remove the tumor, but to allow for optimum functional outcome."

Dr. Ghanem will present this unique case study this weekend at the poster session for the American Academy of Facial Plastic and Reconstructive Surgery annual meeting in Washington, D.C.

The case is centered on a 21-year-old African American male with a history of osteosarcoma, the eighth most common childhood cancer. It affects 5 million patients under the age 20 and about 500 adults ages 15-30 each year in the U.S.

The patient's osteosarcoma spread to his about three years after the initial diagnosis. The facial tumor soon grew to nearly 10 lbs. of tissue and bone, making it difficult for him to speak and eat. The patient required a feeding tube.

Only three months after the surgery, the patient was able to talk and eat without assistance.

Prior to coming to Henry Ford Hospital, the patient underwent multiple treatments including mandible resection, radiation, chemotherapy and cryosurgery at another institution. All treatments were unsuccessful.

Dr. Ghanem and his colleague Francis Hall, M.D., devised a plan that would not only surgically remove the tumor and oral tongue, but rebuild the lower third of the patient's face – all during a 20-hour surgical procedure.

The surgeons performed a near total mandibulectomy (surgical removal of the bone from the lower jaw), and removal of the , mucous membrane from the inside of both cheeks and lower lip.

Dr. Ghanem performed the complex reconstruction of the face and jaw using dual microvascular free flaps from the fibula and shoulder areas.

"The reconstruction involved bone and skin transplanted from the patient's left leg, and a tissue complex from his shoulder blade area with its feeding blood supply compromised of multiple islands of skin and muscles to reconstruct all of the tissues," says Dr. Ghanem.

The subscapular free flap (skin and muscle from the shoulder) is a versatile donor system that offers distinct advantages in the reconstruction of head and neck defects. The shoulder's soft tissue offers mobility, while this area also has a diverse range of skin, bone and muscle available for use in reconstruction of massive facial defects.

Explore further: Ohio State surgeons rebuild pelvis of cancer patient

Related Stories

Ohio State surgeons rebuild pelvis of cancer patient

May 5, 2011
In a rare and medically remarkable operation, a multi-disciplinary team of surgeons at the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute ...

African-Americans 7 times more likely to have keloid scarring of the head, neck

March 6, 2012
African Americans are seven times more likely than Caucasians to develop an excessive growth of thick, irregularly shaped and raised scarring on their skin – known as a keloid – following head and neck surgery, ...

Recommended for you

One weight-loss surgery shows lasting results

September 21, 2017
(HealthDay)—Obesity surgery can have long-lasting effects on weight and the risk of developing type 2 diabetes and high blood pressure, a new study finds.

Hold the phone: An ambulance might lower your chances of surviving some injuries

September 20, 2017
Victims of gunshots and stabbings are significantly less likely to die if they're taken to the trauma center by a private vehicle than ground emergency medical services (EMS), according to results of a new analysis.

Surgeons have major influence on breast cancer treatment

September 13, 2017
A woman's choice of surgeon plays a significant role in whether she's likely to receive an increasingly popular aggressive breast cancer surgery.

Some thyroid cancer patients can safely delay surgery

September 4, 2017
Most people diagnosed with cancer want to start treatment as soon as possible, for fear that delaying care will allow their tumor to grow out of control.

Obese people lack cells with satiety hormones

August 29, 2017
Individuals with severe overweight have an inhibited sense of satiation - they release fewer satiety hormones than people of normal weight. The reason: the responsible cells in the gastrointestinal tract of obese people are ...

Anesthesia and surgery during infancy may impact white matter during childhood

August 24, 2017
General anesthesia and surgery in otherwise healthy infants under the age of 1 year old could be associated with decreases in the amount of white matter in the brain, as well as reductions in the remaining white matter's ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.