Your lower jaw is known as the mandible. Mandibulectomy is the removal of all or part of the lower jaw, with or without removal of the teeth. Area of resection may leave a gap in the jaw bone and floor of the mouth. Your surgeon will discuss with you possible options to reconstruct these gaps.
Option one – Primary closure. Where the remaining soft tissue is stitched together to reduce the size of the wound defect and avoid communication of the oral cavity to neck space.
Option two - Mobilising healthy tissues from another part of your body (for example, your forearm, hip, thigh or lower leg) to rebuild the part that has been taken away. This is called a free flap reconstruction. Free flap reconstruction can be done using only soft tissue to fill the defect and seal the oral cavity. The remaining segments of the mandible may be held in place with a titanium plate or with a free flap with bone.
Your surgeon will explain the possible options for feasible for your case.
Types of Mandibulectomy:
Marginal mandibulectomy: The inferior border of the mandible is left intact preserving the continuity of the mandible.
Segmental mandibulectomy: A segment of lower jaw with/ without jaw joint is resected. This usually requires reconstruction to maintain the jaw function and preserve the shape of the lower face.
Your surgeon may recommend you undergo mandibulectomy for any of these reasons:
You have a benign tumour involving the lower jaw.
You have a confirmed diagnosis of cancer of the lower jaw, tongue or oral tissues close to your lower jaw.
You have a bone infection that does not improve with medical therapy.
The surgery is performed under general anaesthesia. Depending on the size of the tumour, the surgery can be performed through the mouth (transorally) or by making an incision on the skin.
If the surgery is being done because there is a cancer or suspected cancer, your doctor may discuss with you about removing some of the lymph nodes in your neck as well (neck dissection). <insert link to neck dissection>
If there is risk of airway swelling, your surgeon may decide to do a tracheostomy. <insert link to tracheostomy>
There are risks and complications with this procedure. They include but are not limited to the following.
Common risks and complications include:
Pain and swelling
Bleeding- this can happen during or after surgery and rarely can be life-threatening
Loss of teeth in the removed part of jaw or damage to adjacent teeth. You may also have a change in your bite or the way your teeth align.
Changes to speech and swallowing depending on which part of the mandible is removed.
Cosmetic changes of the lower face.
Numbness of the lower lip/ chin area. Rarely numbness of the tongue and change in taste sensation on the operated side.
May need secondary revision or reconstruction of the area
Trismus: tightness of jaw muscles and opening jaw wide