MANDIBULAR TUMORS - Hemimandibulectomy
Larger tumors will need removal of half of the lower jaw, a “hemimandibulectomy”. Reconstruction after this procedure can be made by pieces of a rib threaded on a wire, so called “Shish Kebab”-technique.
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Larger tumor of the right side of the jaw |
Larger tumor of the right side of the jaw |
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Prepared for surgery |
Developping the skin flap |
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Tumor exposed |
Cutting the jaw at the middle |
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Jaw parted at the midline |
Jaw being removed |
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Right half of the jaw with the tumor removed |
large defect after removal of the tumor |
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Removed half of the jaw with the tumor |
Cutting a piece of a rib |
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Piece of rib removed |
The rib is cut in pieces and threaded on a wire |
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Wire with threaded pieces of rib replacing the removed half of the jaw |
Wound closure in progress |
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Wound closure completed |
Patient immediately after surgery |
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Patient before being discharged |
At follow up after three months |
Sometimes the tumor is huge, and the patient is just happy to be relieved of the tumor burden, not bothering about the esthetic result.
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Large tumor of left side of the lower jaw |
Large tumor of left side of the lower jaw |
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Tumor exposed |
Tumor exposed |
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Left half of jaw with tumor being removed |
Half of jaw with tumor removed |
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Large defect after removal of tumr |
Wound closure in progree |
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Patient immdiately after surgery |
Patient before discharge |
The careful observer will have noted that on the last picture a lateral tarsorrhaphy was done (the left eye was closed partially by surgery) to prevent ulceration of the cornea due to lack of lid coverage after lost of blinking reflex. Excision of the facial nerve is unavoidable with these huge tumors, and that is the cause of the post operative facial paresis.