Facial reconstruction for a young man with a tumor in his jawbone

Male patient NQN (29 years old, residing in Quang Ngai ) was found to have a tumor in his lower jawbone 6 years ago, but stopped treatment after an initial monitoring period.

Recently, the swelling increased, and the patient presented to Military Hospital 175 with a swollen lower jaw, mildly inflamed and reddened mucous membranes, and minimal pain. Imaging results revealed a tumor destroying bone from tooth number 44 to the ascending ramus of the right mandible.

The patient underwent mandibular osteotomy, removing the tumor with a safe 1cm margin, and simultaneously reconstructing the mandible using a free fibular musculocutaneous flap. This is a complex technique requiring skill, meticulousness, and endurance from the surgical team. However, with the support of 3D technology, doctors can now accurately simulate each cutting, grafting, and reconstruction step. As a result, surgical outcomes are optimized in terms of both function and aesthetics, providing superior effectiveness for the patient.

On December 2nd, Dr. Do Van Tu (Department of Maxillofacial Surgery, Military Hospital 175) stated that the patient underwent a surgical procedure involving the design of cutting lines and guides for cutting the mandible and fibula using soft tissue models. These guides and 3D models of the jaw were created after simulating bone cutting and reconstruction; the splint was bent according to the pre-simulated model. Then, the mandibular bone segment from the ascending ramus to the distal side of tooth 42 was cut. The fibular skin and muscle flap, after dissection, was cut according to the pre-designed model. The fibula was then attached to a pre-bent reconstructive splint, and the flap and splint were then attached to the mandible to ensure proper occlusion and jaw movement. Finally, microsurgical vascular suturing was performed to ensure the survival of the reconstructive flap.

The doctor checks the patient's condition after surgery.

Ten days after surgery, the patient recovered well. Their overall condition was stable, with no fever, normal vital signs, good fibula flap survival, dry surgical wound, rapid healing, and significant improvement in eating, chewing, mouth-opening, and facial aesthetics.

Dr. Tu explained that the lower jawbone plays a crucial role not only in chewing, speaking, and swallowing but also in shaping the facial structure. Therefore, reconstructing major defects after surgery is always a top priority. Free fibula bone flaps, manufactured using 3D printing technology, offer several advantages, such as ensuring sufficient bone supply for reconstructing large segments, allowing for simultaneous surgery by two teams to shorten surgical time, and increasing accuracy and effectiveness in treatment.

Application of 3D technology in mandibular bone reconstruction

Dr. Tú explained that ameloblastoma is a benign tumor but has the potential to destroy bone and can transform into a malignant form if left untreated. Surgical removal of the tumor from the jawbone often results in significant functional and aesthetic damage, greatly impacting the patient's quality of life, especially in young people.

Currently, 3D technology is increasingly applied in the field of dentistry, such as orthopedic surgery, dental implant surgery, and reconstructive surgery. To optimize treatment results, 3D printing technology has been applied throughout the entire process, from simulation design to surgical planning. This technology allows for the precise design of bone cutting splints and reconstructive plates, the creation of jaw models and surgical guides with high accuracy, ensuring an efficient, safe procedure and optimized treatment outcomes.

Source: https://thanhnien.vn/tphcm-tai-tao-guong-mat-cho-nam-thanh-nien-co-khoi-uo-xuong-ham-185241202120235747.htm