Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Mayo Clinic pioneers new method of jaw reconstruction for oral cancer patients

29.06.2006
Mayo Clinic ear, nose and throat surgeons have developed a promising new process for mandible (lower jaw) reconstruction following removal of oral cancer. Details will be presented June 28 at the International Federation of Head and Neck Oncologic Societies meeting in Prague, Czech Republic, http://www.ifhnos2006.cz.
"We think this new process can be a huge advantage for patients and a good tool for reconstructive surgeons," says Daniel Price, M.D., Mayo Clinic ear, nose and throat surgery resident and lead study investigator. "We're excited about it. It will not completely replace the current mandible reconstruction method -- transfer of bone -- but down the road, I think that this method of reconstruction will be done regularly in patients with cancer involving the mandible."

Patients who might be candidates for the new reconstructive and treatment procedure have oral cancer involving part of the mandible. To completely remove the tumor surgically, surgeons have to remove part of the mandible. Without reconstructive surgery, patients would have difficulty eating and speaking, and would develop a significant facial deformity, says Eric Moore, M.D., Mayo Clinic ear, nose and throat surgeon and senior study investigator.

The new method, which the investigators tested in rabbits, used distraction osteogenesis after tumor removal surgery to restore the missing portion of a patient's jaw. With distraction osteogenesis, the surgeon made a cut at one of the remaining ends of the patient's jawbone. As the break healed, the first phase of growth, soft tissue, appeared. The surgeon then stretched the pliable soft tissue under the tension of a device to fill in the gap in the patient's jaw. Within 24 hours of completing the stretching process, physicians started administering radiation therapy to the mandible to decrease the likelihood of cancer recurrence. As the soft tissue healed, it hardened into bone. The investigators found that the radiation therapy, which they had suspected could interrupt the bone consolidation prior to the study, had no ill effects on the bone's healing.

"Patients with large oral tumors should have radiation therapy after surgery to decrease the chances of cancer recurrence," says Dr. Price. "Radiation needs to be completed 13 to 14 weeks after the patient's cancer diagnosis to achieve maximum effect. As these patients require mandible reconstruction after tumor removal, we wanted to find a way to get both the radiation and the reconstruction done quickly and concurrently."

Dr. Price says that it is also preferable to start the reconstruction when the tumor is removed, as demonstrated in this method, rather than wait until radiation therapy is completed, because immediate reconstruction minimizes scar tissue and is better tolerated by the patient.

The standard procedure for jaw reconstruction following removal of an oral cancer is transfer of bone from the patient's fibula in the leg, along with surrounding muscle, skin and the supplying vessels. Although the aesthetic and functional result for the mandible can be good, this procedure has drawbacks, including:

  • The surgery takes all day to complete and is expensive
  • The patient has a second surgical site to heal (leg and mandible) and is less mobile post-surgery
  • In male patients, the transfer of fibula and surrounding skin can lead to the appearance of leg hair inside the patient's mouth
  • The surgery is not feasible for patients who do not have healthy vessels in their legs
  • The aesthetic result in the leg post-surgery is less than ideal
  • The surgery can inadvertently damage the leg's nerves, leaving the patient with some leg weakness
  • The fibula bone can die following transfer

"If we could avoid the whole process of going to another part of the body in order to reconstruct a patient's jaw, it would be best," says Dr. Moore.

Drs. Price and Moore had been performing similar distraction osteogenesis in children born with small jawbones and wondered about the feasibility of using the procedure for adult oral cancer patients. Thus, they embarked on this research project to test it in animals and have tried this method on human oral cancer patients who were not appropriate candidates for the fibula transfer surgery. They have also utilized the method in patients who have benign tumors or who have suffered a trauma.

The patients who have had distraction osteogenesis performed by Drs. Price and Moore compared the level of discomfort to having orthodontic braces. The devices used for the stretching procedure are submerged and not visible.

The next step in this research, according to Dr. Price, is to study the distraction osteogenesis plus radiation therapy method in larger animals, comparing them to animals who are given distraction osteogenesis without radiation therapy.

Lisa Lucier | EurekAlert!
Further information:
http://www.mayoclinic.com
http://www.mayoclinic.org/news

More articles from Health and Medicine:

nachricht Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania

nachricht The strange double life of Dab2
10.01.2017 | University of Miami Miller School of Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

Im Focus: Newly proposed reference datasets improve weather satellite data quality

UMD, NOAA collaboration demonstrates suitability of in-orbit datasets for weather satellite calibration

"Traffic and weather, together on the hour!" blasts your local radio station, while your smartphone knows the weather halfway across the world. A network of...

Im Focus: Repairing defects in fiber-reinforced plastics more efficiently

Fiber-reinforced plastics (FRP) are frequently used in the aeronautic and automobile industry. However, the repair of workpieces made of these composite materials is often less profitable than exchanging the part. In order to increase the lifetime of FRP parts and to make them more eco-efficient, the Laser Zentrum Hannover e.V. (LZH) and the Apodius GmbH want to combine a new measuring device for fiber layer orientation with an innovative laser-based repair process.

Defects in FRP pieces may be production or operation-related. Whether or not repair is cost-effective depends on the geometry of the defective area, the tools...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Multiregional brain on a chip

16.01.2017 | Power and Electrical Engineering

New technology enables 5-D imaging in live animals, humans

16.01.2017 | Information Technology

Researchers develop environmentally friendly soy air filter

16.01.2017 | Power and Electrical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>