CASE OF THE WEEK – “Management of a big mandibular tumor” by Dr. Shyamsunder Nair, Specialist, Oral & Maxillofacial Surgery, Dr. Sukrith Shetty, Specialist General Surgeon (Surgical Oncologist),Dr. Ayman Moustafa Consultant, Anaesthesiology and Dr. Milind Raje, Counsultant, Radiology at NMC Royal Hospital Sharjah

CASE OF THE WEEK – “Management of a big mandibular tumor” by Dr. Shyamsunder Nair, Specialist, Oral & Maxillofacial Surgery, Dr. Sukrith Shetty, Specialist General Surgeon (Surgical Oncologist),Dr. Ayman Moustafa Consultant, Anaesthesiology and Dr. Milind Raje, Counsultant, Radiology at NMC Royal Hospital Sharjah

A 31year old Nigerian patient visited OPD with a huge swelling on the left side of his face, difficulty in mouth opening ,swallowing and intra oral ulceration .CT with contrast was done and it revealed a multi cystic lesion/Tumor involving the entire condyle- ramus unit of the left side of mandible. It was extending to infratemporal ,pterygoid regions and compressing the airway medially. Biopsy report was Plexiform Ameloblastoma

Due to the anatomical location and size of the tumor meticulous planning was required for a safe resection and reconstruction

Since the tumor had soft tissue extension and high recurrence chances, an intermediate reconstruction was planned

A lip split incision with a cervical extension was planned for tumor access

Synthes reconstruction plate  with a condylar head was planned to replace the resected condyle -Ramus unit

Pectoralis Major Myo cutaneous flap (PMMC) was planned to replace the lost soft tissue and to protect the implant

Elective surgery was done and all pre operative parameters were executed

The histopathology confirmed the earlier diagnosis and margins were free of tumor, Tumor size - 9X8X7.5 cm

Post operative period was uneventful with a precautionary two days ventilation.

Currently patient is rehabilitated and resumed normal diet

It was a challenging and high  risk surgery and managed successfully by a team of doctors comprising of Dr. Shyam sunder(Maxillo- facial surgeon), Dr. Sukrith Shetty (Onco -Surgeon),Dr. Ayman(Anesthesiologist) and Dr. Milind Raje (Radiologist)