How a jaw is rebuilt after cancer surgery, explained by a Mumbai head and neck surgeon

In jaw cancer, removing the tumour to save the patient's life is the foremost priority. But rebuilding the part of the jaw removed during surgery is just as important, as it helps the patient chew food, speak and regain the shape of the face. Dr Amit Chakraborty, a head and neck cancer surgeon at SSO Cancer Hospital, Mumbai, shared details on the subject.

According to Dr Chakraborty, if cancer of the mouth or jaw is at an advanced stage, part of the jawbone may have to be removed along with the tumour. This is necessary to remove the cancer completely, but it can bring a major change in the structure of the face. He said modern surgery now makes it possible to rebuild the removed portion, and the patient can then resume daily activities.

Explaining why reconstruction is needed, the doctor said that when the tumour reaches the jawbone, the affected part of the bone may have to be removed. The patient may then have difficulty chewing, swallowing and speaking, and the shape of the face may also change. According to him, reconstruction is not only to restore the face. The jaw is needed for essential functions such as eating, speaking and swallowing. The main aim of the surgery is therefore that the patient can live as normal a life as possible.

On how the jaw is rebuilt, Dr Chakraborty said that if a large part of the lower jaw has to be removed, doctors can use a surgical technique called free flap reconstruction. In this, a piece of bone is taken from another part of the patient's body, such as the leg, along with its blood vessels. If needed, some skin or muscle can also be taken.

The bone is then shaped to suit the patient's jaw. Using microsurgery, the blood vessels of the bone are joined to blood vessels in the neck. This supplies blood to the newly placed bone and helps the removed portion to be rebuilt.

According to Dr Chakraborty, how quickly a patient recovers depends on several factors: how far the cancer has spread, how much had to be removed, the patient's general health, and whether further treatment such as radiation is needed. Some patients may need treatment to restore teeth, physiotherapy and special therapy to practise speaking and swallowing.

According to the doctor, it is essential to plan how the jaw will be rebuilt at the time of the cancer surgery itself. Doctors have to consider in advance that, after surgery, the patient should be able to eat, speak and have dentures fitted. How much is to be removed and how the jaw is to be rebuilt are decided accordingly.

Dr Chakraborty said modern head and neck surgery techniques are bringing great relief to patients being treated for jaw cancer. Removing the cancer completely is doctors' first goal. Jaw reconstruction also helps the patient eat, speak and lead daily life with confidence again, improving their quality of life.