Often used as a treatment for head and neck cancer, a mandibulectomy involves the surgical removal of all or part of the lower jaw.
What is a mandibulectomy?
A mandibulectomy is a type of surgery used to remove all or part of the lower jaw (the mandible). It is often used to remove a tumour caused by head and neck cancer. Your surgeon may also extract any affected teeth if necessary.
The amount of lower jaw removed depends on the size and location of the tumour. Your surgeon will also remove a portion of healthy tissue surrounding the tumour, so that they can be certain the cancer cells are gone. Occasionally, you may also need lymph nodes removed from your neck (neck dissection).
A mandibulectomy is usually combined with free flap surgery to immediately restore the appearance and function of the jaw.
At Cromwell Hospital, we treat more cases of jaw cancer than any other private hospital in the UK. Our surgeons have pioneered the latest advances in jaw surgery, including the use of Piezo saws which help to preserve nerves and blood vessels, as well as reducing swelling and pain. Our team also use the latest advances in 3D techniques to plan your surgery and reconstruction, helping achieve the most consistent and accurate results possible.
A mandibulectomy is used for patients who have a tumour growing in their lower jaw. This is usually as a result of cancer, although benign tumours can also occur.
A mandibulectomy is also occasionally used to treat a condition called osteoradionecrosis. Osteoradionecrosis is a rare complication of radiotherapy, where the bone becomes damaged and is unable to heal itself.
You will have either a partial or segmental mandibulectomy, depending on the size and location of the tumour. Your surgeon will also remove a portion of healthy tissue surrounding the tumour, so they can make sure that no cancer cells are left behind.
A partial mandibulectomy (also known as a rim resection) involves removal of part of the lower jaw. If the tumour is small enough, an incision will be made through the mouth. Some patients will not need reconstructive surgery after this type of mandibulectomy.
A segmental mandibulectomy involves the removal of the full thickness of the lower jaw. This type of mandibulectomy requires reconstructive surgery to restore the appearance and function of the lower jaw.
Immediately after surgery, you may be temporarily placed in the Intensive Care Unit (ICU) for close monitoring. You will remain in hospital for one to two weeks following your mandibulectomy.
When you wake up from surgery, you can expect to have the following:
- Tracheostomy – This is a tube which is placed temporarily in your trachea (windpipe) to help you breathe during recovery.
- Drains – Drains are plastic tubes which are placed at the surgery site to carry away any excess fluid.
- Fluid drip and feeding tube – You will have a drip placed in your arm and a feeding tube placed in either the nose or stomach to help keep you nourished and hydrated until you can eat and drink normally again.
- Catheter – This is a tube that is inserted into your bladder to allow urine to drain.
If you have had free flap surgery in addition to your mandibulectomy, you will also need to allow time for your donor site to heal.
Throughout your stay, you will be visited regularly by a dietician and speech and language therapist to help support you with eating, drinking and talking. If you have had donor tissues taken from your leg or hip for jaw reconstruction, then you will also have physiotherapy to help you regain normal movement.
Upon discharge, you will have continued support from the head and neck team to help facilitate your recovery from home. You can expect to be off work for a minimum of one month, but often longer.
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