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Mandible Reconstruction with Fibula Free Flap. Is this an option?
In cases of radiation to the jaw resulting in Osteoradionecrosis (radiation bone death) or Ameloblastoma or similar growths on the mandible, reconstruction surgery is sometimes recommended. The mandible (lower jaw bone) has become constantly infected, weak causing pain, teeth failing, habitually sore or troublesome, after radiation therapy often years in the past. Your doctors or dentists may be suggesting surgery. Ameloblastoma patients sometimes have little choice due to the tumor often embedded in the mandible itself. While there are options to mandible reconstruction, what works very well is replacement of the infected section with your own transplanted bone and tissue.
When replacing a mandible section with harvested bone, the bone section selected will have the blood supply attached (free flap) which will be reconnected to an existing artery to keep the bone alive. This allows for healing and complete attachment to the existing mandible. Mayo Clinic Rochester, one of only a few places in the world that perform this type of surgery, uses either a section of bone from the Fibula or from the hip or shoulder area. The Fibula is a flexible bone in the lower leg which is non-weight bearing and won’t be particularly missed.
Dr’s Arce and Ettinger among others in the Oral and Maxillofacial Surgery group removed a section of my left fibula and surrounding tissue and fit that precisely into my left mandible along with peg inserts to support prosthetic teeth. 3-D models of my jaw were worked up and used as templates prior to surgery so that everything fit as necessary. The entire procedure for my end was about six hours of happy sleep. Recovery was a bit longer of roughly a week before I was released from hospital.
I had a feeding tube installed for nutrition and medication as well as a CAM-boot on my leg to promote healing. The feeding tube was removed after three weeks whilst the CAM-boot was probably gone after two. The healing while not comfortable was certainly manageable and I returned to work (restricted mostly to a desk) about four weeks after surgery.
Healing continued with return visits to Mayo for teeth prosthesis and to have my trach closed, which it did not do on it’s own because things like that happen to me. Nine months out I was eating corn on the cob for the first time in many years and walking without issue, miles per day. Now two years out, other than meticulously cleaning my teeth thrice-daily, I really have no issues with eating, talking, or walking. The healing was certainly much faster than the cancer treatments that proceeded this adventure twenty years prior.
Has anyone else been troubled by teeth or jaw since radiation or surgery? Has Mandible Reconstruction been considered?
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Another question ❓ Did you get both upper and lower teeth? Did they do them when you got your first surgery? Thanks
Lower left side only. Pegs were installed in the bone graft when the resection was performed. If I elected at that time not to have pegs installed, having a permanent prosthetic later on would not be an option.
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1 ReactionOk thanks. I only have a few teeth left on good side on top of mouth. They are broken though. Bottom 4 teeth pulled next week cuz I have lots of pain been on antibiotics 3 times. So I will only have a few then. I'm hoping they can fix all of them so I can eat meat and food again. Do you know of any medical flight that travel there. The one I called said they only go to Arizona and the west coast. Hope you have a great day.
You could try angelflight.com and there are others as well. Some airlines (southwest) have medical discounts. Rochester has an airport with shuttles so many folks don't bother with a rental car. Minneapolis MSP airport is another option being only about an hour drive away where often the flights are cheaper than directly into RST. Delta is the main airline in both locations.
I certainly do not miss the weeks/months/years of antibiotics and tooth pain. I wish you well.
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1 ReactionThyi did try Angel flight. But they said they only travel to mayo in Arizona or the west coast. I need to go to Rochester. I can't wait till I don't have to deal with pain pills etc anymore. I can't wait for the outcome.
Darcie, where are you located?
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1 ReactionColumbia Falls Montana. Our airport is glacier national
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1 ReactionDarcie,
You can call the Patient Travel Services at Rochester 866-551-3392 and be ready with your patient account number. Also check out the web page Mayoclinic.org and tab on Care at Mayo Clinic, then Patient Visitor Guide. Fill out the request form. No guarantees.
I see where you are located. Small aircraft usually won't do mountain flying in the winter which leaves us with jet service only. Angelflightswest for your district doesn't go east past Montana. There are other organizations out there other than Angel Flights. We have one here in the Midwest which I participate with.
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3 ReactionsThanks
@darcybechtel67, I agree with @hrhwilliam to call Mayo Patient Travel Services at Rochester. You may also wish to talk to someone at Mayo Clinic's Concierge Services to discuss options.
Concierge services are complementary and available in person or by phone, live chat, email or online form.
Here is information for Contacting the Concierge Services:
– In person: Concierge Services desk
Mayo Building (lobby level, in the International Center)
Monday-Friday: 8 a.m. to 5 p.m.
No appointment necessary
By phone 7 a.m. to 6 p.m., Monday-Friday: 507-538-8438
Email: concierge@mayo.edu
Online: Request Concierge Services (if you go to the link below, you can link directly to this )
Concierge services
https://www.mayoclinic.org/patient-visitor-guide/minnesota/concierge-services
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