Senior Consultant, Surgical Oncology & Chief, Head & Neck Oncology, Paras HMRI Hospital, Patna ( July 2014 onwards): Joined Paras Hospital to develop a world class comprehensive cancer surgery services with latest facilities in this region apart from advanced oncosurgery for head and neck cancer and microvascular free flap reconstruction.
Jaw bone is an important structure of face, which provides function as well as cosmesis. Jawbone or mandibular or gum cancer is a type of oral cavity cancer, arises from mucosa lining of upper or lower gingiva or gum or mandible. Dentist are typically the first to notice signs of gum cancer, often during a routine dental examination or with loose teeth, ill-fitting denture or other dental problems.
Biopsy is required for confirmation of diagnosis. CT scan for extent and infiltration of disease. Surgery recommended for early as well as advanced disease. Marginal mandibulectomy, segmental mandibulectomy or hemi mandibulectomy may be required, depends upon location and extent of primary tumor. For lateral defect in an elderly patient or with decreased mouth opening, soft tissue flap either regional or free flap may be adequate. With good mouth opening in a younger patient, jaw bone reconstruction with free bone flap in the form of free fibula flap is an excellent option.
Central jaw bone tumor necessarily requires free bone flap reconstruction of mandible with free fibula bone to support the floor of mouth and tongue, otherwise these patients require prolonged tracheostomy tube and nasogastric feeding tube, leading to poor quality of life. Free bone flap microvascular reconstruction of central mandible defect helps in early removal of tracheostomy and nasogastric feeding tube, improves functional outcome and gives better quality of life.
Postoperative adjuvant radiotherapy or adjuvant chemo-radiotherapy depending upon histopathology report.