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Excision of malignant tumor of mandible
CPT4 code
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
- Administration of general anesthesia to ensure the patient is asleep and pain-free.
- An incision is made in the gum or skin overlying the mandible to access the tumor.
- Surgical instruments are used to carefully excise the tumor along with a margin of healthy tissue to ensure complete removal.
- Reconstruction of the mandible may be necessary, using bone grafts or reconstruction plates.
- Closure of the incision with sutures.
- 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.