RID THE PATIENT OF CANCER AND RESTORE THE LOST JAW USING THE LATEST TECHNOLOGY

A man from the city of Smolensk applied to the microsurgery department. He had been treated for a long time for inflammation in dentistry. But despite timely help and a negative morphologic analysis with altered mucosa of the mandibular alveolar process, the inflammation continued and the pain increased. The patient was advised to go to a federal center for revision of morphological materials. And the specialists of the pathomorphologic department of the P. Hertsen Moscow Oncology Research Institute (MORI) – branch of the FSBI “National Medical Research Radiological Centre” (NMRRC) of the Ministry of Health of the Russian Federation, managed to find the cause.

The man was diagnosed with a tumor process cancer was hiding behind inflammation in the deep layers of the lower jaw. “We had to perform the analysis three times before we could fully clarify the diagnosis of highly differentiated squamous cell cancer, says the researcher, surgeon-oncologist of the Department of Head and Neck Microsurgery, Candidate of Medical Sciences A.V. Mordovsky. By the time we contacted the federal centrе, the tumor process had already affected the entire lower jaw. So we included in the surgery plan not just the removal of the affected area, but also a one-stage restoration of this part of the facial skeleton using a skin-muscle-bone autograft from the fibula”.

The operation lasted about 7 hours. One team of surgeons under the guidance of a senior researcher of the P.Hertsen MORI, Candidate of Medical Sciences I.V. Novikova removed the entire affected bone part with the adjacent soft tissues and neighboring lymph nodes on the right side. At this time, another, according to a pre-made individual plan using 3D models, formed and prepared for transplantation of the autograft fragment itself from the fibula with surrounding soft tissues and their feeding vessels.

“We transferred the autograft to the area of the previously resected mandible and fixed it with a customized titanium plate,” continues A.N. Mordovsky. After all actions in the operating room took place under a microscope: the surgeons sewed all the vessels and nerve endings to restore nutrition to the transplanted tissues. The operation was completed successfully.

Next, the patient will have to undergo a course of radiation therapy to maximize the risk of recurrence of the disease. And only after completion of the full anti-tumor treatment will it be possible to start dental rehabilitation, i.e. restoration of teeth.

“Such complex microsurgical operations with reconstruction are performed in our country in only two other oncological centers, emphasizes the General Director of the National Medical Research Radiological Centre” (NMRRC) of the Ministry of Health of the Russian Federation, Academician of the Russian Academy of Sciences A.D. Kaprin. We have put them on the stream, and the Center has the greatest experience in their application. Modern oncological care is unthinkable without rehabilitation of patients, their return to normal, familiar life. And we try to develop the reconstructive element in all types of surgical care we provide to our patients”.