Mandibulectomy and Fibula Free Flap Reconstruction
Mandibulectomy is a surgery to remove all or part of your jaw, also called as mandible, if you have a cancer growing into the jaw or very close to it.
Some facts about Mandibulectomy and Fibula Free Flap Reconstruction:
- Mandibulectomy is required if you have a tumor involving your jaw.
- Your jaw will be rebuilt by using the bone from another part of your body which is called as the donor site.
- The bone may be taken from your fibula in your lower leg. An artery, vein, and soft tissue will also be removed along with the bone which is called a fibula free flap.
- Leg is used as the donor site in most jaw reconstructions. Your jaw can also be rebuild by using a bone from a different donor site.
- A skin graft is also required to cover your donor site.
- The top layer of skin from one part of your body will be taken and it will be moved to the surgical site that needs to be covered in a skin graft.
Preparation for Mandibulectomy:
The decision of a Mandibulectomy will be taken by your head and neck surgeon, your plastic surgeon, and your dentist combinely.
Computed tomography (CT) scan(s) and x-rays will be taken to assess the amount of tumor in your jaw and will be used to make a model of your new jaw before surgery.
Photographs of your face will be taken which will be used during the reconstruction.
Magnetic resonance (MR) or CT, of your donor site will be conducted to evaluate the blood vessels in your donor site.
Procedure for Mandibulectomy:
- Mandibulectomy will be performed by 3 surgical teams, including a head and neck team, a plastics team, and dental team.
- The tumor from your jaw and the soft tissue around it will be removed by your head and neck surgeon.
- The bone, tissue, and skin from your donor site will be removed by your plastic surgeon at the same time which will generally take 3 to 4 hours.
- The tumor and surrounding tissue will be send to the Pathology Department for testing.
- The reconstruction can be done once your head and neck surgeon has completed their part of the surgery.
- The tissue from your donor site will be transferred by your plastic surgeon to reconstruct your jaw.
- The bone from your donor site will be shaped to match the piece of your jaw that was removed as closely as possible.
- The new jaw bone will be fixed in place with plates and screws and cover it with the soft tissue.
- Stitches will be placed in your face and neck by your plastic surgeon to connect them to the soft tissue.
- Usually, the reconstructive part of the surgery takes 6 to 8 hours.
- A temporary arch bars and rubber bands may be placed in your mouth by your dentist during your reconstruction to keep your teeth and jaw correctly aligned.
- The rubber bands will be removed 5 to 7 days after your surgery and the arch bars 14 days after your surgery by your dentist.
