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Face and Jaw Surgery

Cancer survivor and radiation issues

05/02/2007

Question:

I had cancer of the parotid (left side) which went undetected for 6 years. Misdiagnosed w/Bells ... long story. The cancer burst through the tumor, advanced into facial nerves and mastoid. Had BIG radiation on left side, many corrective surgeries, still looks impaired to an extent. Recent years have had tooth loss and bone "compromise in left mandible. Sent to hyper baric - one month, teeth extracted, began to rebuild with bridges. Lots of stress causing me to clench and grind, sleep apnea, etc. Always have chewed gum to keep moisture in mouth - double edged sword - I know. I teach so talking is a function of my workday as well. Now I am having severe pain with chewing. And if it is quiet enough the screaming I can hear in my ear can be heard by everyone else at the table. The pain is tremendous. Dentist did panorex and very clearly the jaw on the left looks a mess compared to the healthy right side. Where to go from here? Back to hyper baric and then surgery to rebuild the jaw? Would wiring the jaw be reasonable prior to returning to hyper baric? Would wiring be helpful in realigning? Do I plunge right into jaw replacement or could wiring be a "worth a try" type procedure? I am plump - so weight loss would not be a huge risk - actually it could be quite pleasent since I am 50 and those extra pounds are tough to lose. Your thoughts are very important to me as I don`t like to go into my docs without some knowledge of what the possibilities may be. I have many trust issues since the original TWO docs that took my cancer for Bells and me being a hypochondriac.

Answer:

It appears that the therapy (hyperbarics) to this point is within reason. However, I am a prosthodontist (prosthetic rehabilitation) and cannot answer your questions regarding rebuilding the jaw and wiring.  For this reason, I am forwarding your questions regarding upcoming care to an oral surgeon who I hope can give you the help/answers that you need regarding this. Take care.

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Response by:

Meade C van Putten, DDS, MS Meade C van Putten, DDS, MS
Associate Professor of Primary Care Dentistry
College of Dentistry
The Ohio State University