21044 Excision of malignant tumor of mandible

Name of the Procedure:

Excision of Malignant Tumor of the Mandible

Summary

This procedure involves the surgical removal of a cancerous growth from the lower jawbone, known as the mandible, to prevent the spread of cancer and alleviate associated symptoms.

Purpose

Addresses:

• Malignant tumors located in the mandible. Goals:
• Complete removal of the tumor.
• Prevention of metastasis (cancer spread).
• Restoration of jaw function and appearance.

Indications

• Presence of a diagnosed malignant tumor in the mandible.
• Symptoms such as pain, swelling, or functional impairments in the jaw.
• Positive results from imaging tests and biopsies indicating malignancy.

Preparation

• Fasting for at least 8 hours prior to surgery.
• Adjustment or discontinuation of certain medications as advised by the surgeon.
• Pre-operative imaging (CT scans, MRIs) and blood tests to assess the extent of the tumor.
• A thorough medical evaluation including a dental assessment.

Procedure Description

1. Administration of general anesthesia to ensure the patient is asleep and pain-free.
2. An incision is made in the gum or skin overlying the mandible to access the tumor.
3. Surgical instruments are used to carefully excise the tumor along with a margin of healthy tissue to ensure complete removal.
4. Reconstruction of the mandible may be necessary, using bone grafts or reconstruction plates.
5. Closure of the incision with sutures.
6. Application of a sterile dressing to the surgical site.

Duration

Typically takes 3 to 5 hours, depending on the complexity of the tumor and the extent of reconstruction required.

Setting

Performed in a hospital operating room.

Personnel

• Oral and maxillofacial surgeon.
• Surgical nurses.
• Anesthesiologist.
• Possibly a plastic or reconstructive surgeon if complex reconstruction is needed.

Risks and Complications

Common risks:

• Bleeding
• Infection
• Swelling Rare complications:
• Nerve damage (potentially affecting sensation or movement in the jaw)
• Difficulty with jaw function
• Issues with bone healing

Benefits

• Removal of the malignant tumor
• Prevention of cancer spread
• Improvement in symptoms and potentially life-saving

Recovery

• Hospital stay for 2 to 4 days.
• Pain management with prescribed medications.
• Soft diet or liquid diet initially, progressing to solid foods as tolerated.
• Follow-up appointments for wound care and monitoring recovery.
• Expected recovery time of several weeks to a few months.

Alternatives

• Radiation therapy: Non-invasive but may not be sufficient alone.
• Chemotherapy: May be used in conjunction with surgery; usually not effective as a sole treatment for mandibular tumors.
• Palliative care: For those who may not be candidates for surgery.

Patient Experience

• Complete sedation during the procedure.
• Post-operative pain managed with medications.
• Swelling and discomfort at the surgical site.
• Possible temporary or permanent changes in jaw function and facial appearance.
• Requirement to adhere to post-surgical care instructions for optimal recovery.