Mandibulectomy Surgery in Mumbai, India

Mandibulectomy is a surgical procedure to remove a part of the mandible (jaw bone). The most common indication of the need for this procedure is the presence of a tumour in the mandible. It is of two types - marginal and segmental mandibulectomy. Marginal mandibulectomy involves removing only part of the jawbone affected by the tumour. However, the entire mandible is removed and replaced with a reconstructed jaw bone in segmental mandibulectomy.

Alternative Name

Mandibular Resection

Procedure Type

Surgical procedure

Location

The mandible is the lower jawbone.

How is Mandibulectomy Performed?

Mandibulectomy is performed under general anaesthesia so that the patient will be completely unconscious during the procedure. A tube may be inserted into the windpipe, and a feeding tube may be required after the surgery until the patient can eat again. The incision is made in the neck and the lower lip, chin, or mouth, depending upon the tumour's location. The affected bone is removed along with the teeth. A nerve also passes through the mandible, which may need to be removed. In some cases, if the spread of cancer is more, the tongue, cheek, floor of the mouth, and the lymph nodes in the neck may also be removed.

This is followed by reconstructive surgery to improve the appearance. The patient can speak and eat again. Bone from other body areas such as the back, arm, hip, or leg is used to reconstruct the jaw bone; skin flaps and grafts are made to give a natural look. Dental implants may also be required to replace the removed teeth.

Preparation for The Mandibulectomy Procedure

It is advised to clarify all doubts and queries from the doctor before the procedure. Some of the required preparation pointers are:

• Fasting: The patient will be required to fast at least six hours before the surgery.
• Medications: Certain medications, such as blood-thinning medicines, are contraindicated before the surgery. Please ensure to confirm which medicines are safe to consume.
• Visit a Dentist: If certain teeth need to be removed during the surgery, the dentist might need a mould of the patient’s teeth to plan dental implants.
• Communication: If the jawbone, teeth, and tongue are removed, eating and speaking can become difficult. Before the surgery, it is recommended to have an alternate way of communication.

Follow up

Regular follow-ups will be required with the surgeon and other allied health professionals such as speech therapists, dieticians, dentists, and other specialists.

Risks of Mandibulectomy

Certain risk factors such as blood clots and bleeding are associated with every surgical procedure. Risk factors are specific to mandibulectomy are:

• Abnormal opening or fistula: This may occur if the seal separating the mouth and neck breaks down, resulting in leakage of saliva. It can be rectified surgically.
• Flap failure: The skin flap placed during the reconstruction may get damaged due to inadequate blood supply. It may be repaired by replenishing the blood supply or replacing it entirely.
• Non-union: The non-union of the reconstructed jaw bone may require another surgery if the bone is not stable.
• Wound infection: A bacterial infection of the surgical wound might occur that can be treated with antibiotics.

Recovery After Mandibulectomy

The recovery is gradual after mandibulectomy and may depend on the extent of the jaw bone and surrounding structures removed. The patient may have to take medications to counter pain and nausea. Weakness can be expected, so it is advisable to take adequate rest and allow the body to heal.