Jaw Reconstruction Method for Oral Cancer Shows Promise in Animals

By Anthony J. Brown, MD

NEW YORK JUN 29, 2006 (Reuters Health) - Surgeons have devised a method of reconstructing the jaw after oral cancer resection that does not require transferring bone from another part of the body, according to animal study findings presented Wednesday at the International Federation of Head and Neck Oncologic Societies in Prague, Czech Republic.

"The gold standard for jaw reconstruction after removal of (bone-infiltrating) tumors is fibula transfer surgery," Dr. Eric Moore, from the Mayo Clinic in Rochester, Minnesota, told Reuters Health.   "While outcomes are generally good with this procedure, there are a number of drawbacks," most of them related to the creation of a second surgical site, he added. 

This problem led Dr. Moore"s team to considering using distraction osteogenesis to fill in the mandibular defect left after cancer removal.  The technique, which has been applied to children with small mandibles, involves the use of a device that stretches a surgical cut in the bone, which then fills first with soft tissue to bridge the defect.  Over time, this tissue hardens to become bone.

One main concern in applying distraction osteogenesis to oral cancer patients was how this technique would fit in with radiation therapy, which has been shown to reduce the risk of disease recurrence.  In particular, Dr. Moore said his team was fearful that "radiation therapy, which should be given within 6 weeks of resection, might disrupt the bone consolidation" achieved with the technique, which is begun immediately after resection. 

Testing of the technique in rabbit models of oral cancer showed this concern to be unfounded: there was no evidence that the radiation therapy adversely affected bone healing.

Dr. Moore said that "distraction osteogenesis could represent a viable option for patients lacking healthy blood vessels in the legs," making them poor candidates for fibula transfer surgery.  Perhaps, he added, one day it might even supplant fibula transfer surgery altogether.

Dr. Moore said his team has now applied distraction osteogenesis to two patients with oral cancer.  "It"s still early, but so far things are going well."


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