Oral Reconstruction

Oral cancer is a disease that is striking more individuals each year. Last year approximately 34,000 individuals were diagnosed with some type of oral cancer. Of those, at least 5000 have died. Because oral cancer is difficult to diagnose in its early stages, and therefore receive adequate treatment, many individuals are forced to undergo major surgery to remove the tumor. (1)

Surgical removal of oral cancer tumors can involve the mandible, maxilla or voicebox. This means potentially removal of part of the upper jaw, lower jaw or complete removal of the structure in which allows individuals to speak. In the case of removal of the voicebox or of the lower jaw, sufferers will have to have a tracheotomy. This is a tube placed in the throat that exits to the outside which allows the individual to breathe.

The priority during the treatment phase for oral cancer is to maintain life, and a good quality of life. Surgeons will also take into account the plastic surgery required in order to reconstruct the face once the tumor has been removed.

Before these intensive surgeries and procedures are begun patients will undergo extensive evaluation and planning to ensure the best possible care and results. Today, plastic surgeons have the ability to use computer generated graphics to give their patients an idea of what the results will look like.

Plastic surgeons will use photography and then computer aided graphics to generate a plan for reconstruction using either cadavar bone, donated skin or self-graphs from another area of the body.

Reconstructive surgery is very expensive, but well worth the effort and expense when considering the emotional and psychological future of the patient. In some instances insurance companies will pay for reconstructive surgery that goes beyond functionality. However, to receive reconstructive surgery by a skilled plastic surgeon that addresses of visual aspects of the face, most surgeons and patients must use letters of medical necessity in order to convince insurance companies of the necessity of the surgery for the health of the individual.

Part of the reconstructive process will address any bone and soft tissue that was lost during the initial surgery to remove the tumor. Another part of the reconstructive process will address previous issues that may have been the result of tooth decay or loss. Reconstruction may be able to be accomplished with one surgery but more often, for a truly successful result in instances when a large amount of tissue was removed, reconstruction must occur in stages.

Doing surgery in stages will help the tissue to mend more naturally and give the patient a more natural appearance. This is especially important in individuals who have had a cure from their cancer. Reconstruction is not usually attempted in individuals who continue to require chemotherapy and radiation to treat their cancer.

Reconstruction for oral cancer is best attempted by experienced plastic surgeons who will look out after all aspects of the surgery and recovery process for cancer sufferers.

(1) Oral Cancer foundation: Facts
http://www.oralcancerfoundation.org/facts/

RESOURCES

Oral Cancer Foundation: Overview of Oral and Fascial Restoration and Rehabilitation
http://www.oralcancerfoundation.org/restoration/index.htm

Jefferson University: Use of Tongue Flaps in Oral Reconstruction
http://www.jefferson.edu/omfs/pdfs/tongue_flaps.pdf

University of Texas Medical Branch: Lip Cancer and Reconstruction
http://www.utmb.edu/otoref/grnds/lip-recon-2011-Dec/lip-recon-pic.pdf

Kansas City Surgical Arts: Oral Reconstruction
http://www.kansascitysurgicalarts.com/

Archives of Otolaryngology: A Comparison of Three Methods of Oral Reconstruction
http://www.ncbi.nlm.nih.gov/pubmed/3551996