Mandibulectomy is a removal of part of the jaw bone (mandible). This is used when cancer is involved with or close to involving the jaw bone. The defect is then reconstructed with metal plates and/or bone from another area of the body.
- Before surgery, the patient meets with their team of health professionals, including the surgeon, oncologist (in charge of chemotherapy, if needed), radiation oncologist (in charge of radiation therapy, if needed), and speech pathologist/speech therapist. Together, a plan is made so that everyone is clear about the patient’s goals, treatment, and care.
- There are risks to any surgery; the specific risks will be discussed by your doctors with you.
Directly after surgery, a patient is usually monitored at least 24 hours in the Intensive Care Unit, with nurses checking up on them every hour. When ready, the patient will be transferred to a Step-Down care unit. There, a patient can rest and nurses will check on them every 2–4 hours. Patients are usually kept in the hospital for five to 10 days and can go home with family assistance and a nurse that checks in a few days a week.
- The muscles of the tongue, cheeks, and floor of the mouth connect to the mandible. Therefore, swallowing and speaking will be different after surgery. A speech therapist will work with the patient to retrain the muscles. This will either happen while the patient is in the hospital or clinic. Expect it to be difficult at first.
- Nutrition after surgery will be either through a feeding tube inserted through the nose that goes into the stomach (nasogastric/NG tube) or through a tube inserted through the skin directly into the stomach (gastrostomy/G tube).
Some patients keep a tube feeding system when they go home because they are not yet ready or able to take nutrition through their mouth. It is very important to have both good nutrition and hydration. In general, patients will be trialed on liquids five days after surgery, unless they have had radiation treatment, in which it will be done for 10 days post-surgery.
- If the mouth is expected to become swollen after surgery, a tracheostomy is performed at the same time as the mandible surgery.