My Child has a Jaw Tumor. What are the Challenges of Jaw Tumor Surgery?
Jaw tumors are common in children and although usually are not cancerous, they most often require surgery as first line of treatment. Tumor removal can cause significant jaw and face deformity in the young patient and future problems with growth and function. Jaw reconstruction in children is also challenging as one has to restore the child’s facial features along with the ability to properly chew and continue to grow without restrictions. Early return to school and to normal physical activities are also extremely important for children. Finally, it is imperative that the tumor, once removed, does not return. For these reasons, surgery for the growing child is often complex and is best performed by a dedicated and experienced pediatric surgical team made up of experts in tumor removal and, as importantly, reconstruction of the jaws.
How can the Surgical Team Ensure that My Child will Look and Function the Same After the Jaw Tumor Surgery?
Surgeons nowadays use very sophisticated methods and technological advances to treat jaw tumors in children. Bone, skin, and/or muscle tissue moved from one part of the body to another is commonly carried out to restore defects after tumor removal surgery. The bone from the outer part of the leg, the fibula bone, is most often used to reconstruct the jaws after removal of large jaw tumors. Digital technology allows the surgeon to use the child’s 3-dimensional imaging to precisely plan and execute both the removal of the tumor and reconstruction of the jaw. The surgical team can design the entire surgery virtually (computer simulation) and accurately plan every step for each procedure. The tumor is precisely outlined digitally along with surrounding structures (nerves, teeth), and the amount of jaw bone needed to safely remove the tumor is measured and marked digitally (Fig 1). Then, the child’s own fibula bone is modified to recreate the removed jaw bone (Fig 2). Next, a titanium metal plate that mimics exactly the patient’s contours is designed to hold the jaw and fibula pieces together (Fig 3). For children who will end up losing some teeth as part of the tumor removal, the digital planning can include the location of dental implants that will eventually replace the missing teeth. These plans are used by the surgical team at the time of the surgery to execute the planned procedures with the highest possible accuracy. The surgical team also uses these digital surgical plans to explain the details of the entire operation to the child and family and answer any questions before surgery.
The full article can be accessed at https://www.joms.org/article/S0278-2391(20)31335-5/fulltext
The Journal of Oral and Maxillofacial Surgery is published by the American Association of Oral and Maxillofacial Surgeons to present to the dental and medical communities comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral and head and neck cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment, and modern therapeutic drugs and devices.