Excision of malignant tumor of mandible; radical resection
CPT4 code
Name of the Procedure:
Excision of Malignant Tumor of Mandible; Radical Resection
Common Name(s): Mandibular Tumor Resection, Radical Mandibular Excision
Summary
Radical resection of a malignant tumor in the mandible is a surgical procedure where the affected portion of the lower jawbone is completely removed to eliminate cancerous tissues. This procedure is used when the tumor is large or has spread to surrounding structures.
Purpose
This surgical approach addresses the presence of a malignant tumor in the mandible (lower jaw). The goal is to ensure complete removal of the cancerous tissue to promote better health outcomes, prevent the spread of cancer, and potentially improve the patient's survival rate.
Indications
- Diagnosis of a malignant tumor in the mandible.
- Symptoms such as pain, swelling, difficulty chewing, or changes in bite.
- Confirmation through imaging and biopsy that the tumor is cancerous.
- Situations where less invasive treatments are not viable.
Preparation
- Patients may be required to fast for at least 8 hours prior to surgery.
- A thorough dental and medical evaluation will be conducted.
- Imaging tests such as CT scans or MRIs to map the tumor’s location and size.
- Adjustments or cessation of certain medications as advised by the healthcare provider.
- Preoperative blood tests and possibly a biopsy.
Procedure Description
- Anesthesia: Administered general anesthesia to ensure patient comfort.
- Incision: An incision is made in the gum line or beneath the jaw to access the mandible.
- Resection: The surgeon excises the tumor along with a margin of healthy tissue to ensure all cancerous cells are removed.
- Reconstruction: Depending on the extent of the resection, reconstructive surgery may be performed using bone grafts or prosthetic implants.
- Closure: The surgical area is closed with sutures, and drainage tubes may be placed if needed.
Duration
The procedure typically takes between 4 to 6 hours, depending on the complexity and extent of resection and reconstruction needed.
Setting
The surgery is performed in a hospital's surgical suite, often requiring an inpatient stay.
Personnel
- Head and neck surgeon
- Anesthesiologist
- Surgical nurses
- Potential support from a plastic or reconstructive surgeon
Risks and Complications
- Infection
- Bleeding or hematoma
- Nerve damage leading to numbness or weakness
- Jaw function impairment
- Anesthetic risks
- Potential need for further reconstructive surgery
Benefits
- Complete removal of the malignant tumor, reducing the risk of recurrence.
- Alleviation of symptoms caused by the tumor.
- Improved overall prognosis and quality of life post-recovery.
Recovery
- Hospital stay of 1-2 weeks post-surgery.
- Pain management with prescribed medications.
- Instructions on a liquid or soft diet initially.
- Regular follow-up appointments to monitor healing.
- Physical therapy for jaw function if needed.
- Total recovery may take several months.
Alternatives
- Radiation therapy, which might be less invasive but less effective for large tumors.
- Chemotherapy, often used in conjunction with surgical approaches.
- Partial resection or palliative care if the surgical risk is too high or if the tumor is not fully resectable.
Patient Experience
Patients will be under general anesthesia during the procedure, so they will not feel any pain. Post-operatively, some discomfort and swelling are expected. Pain management strategies will be in place, and supportive care measures will ensure comfort during the recovery period. Follow-up visits will help monitor progress and manage any complications.