What is a marginal Mandibulectomy?

Reviewed on 1/13/2021

The mandible is the lower jaw. Mandibulectomy is a surgical procedure to remove a portion of the mandible while treating oral cavity cancer.
The mandible is the lower jaw. Mandibulectomy is a surgical procedure to remove a portion of the mandible while treating oral cavity cancer.

There are two types of mandibulectomy:

  • Marginal mandibulectomy: It involves only the removal of the cancerous area. There is no need for reconstructive surgery because a majority of the jaw is left.
  • Segmental mandibulectomy: It involves the removal of the entire jaw. The jaw needs reconstruction after the procedure. For reconstruction, the bone from the leg, back, arm, or hip is taken to make a new jaw.

Marginal mandibulectomy should be avoided when:

When is marginal mandibulectomy indicated?

Marginal mandibulectomy is indicated in the following conditions:

  • A tumor that has spread near the jawbone but has not yet invaded it.
  • Osteonecrosis (loss of blood flow to the bone tissue) of the mandible due to bisphosphonates (a type of medicine).
  • Osteoradionecrosis (bone death) of the jaw following head and neck radiotherapy.

What are the risks of marginal mandibulectomy?

Mandibulectomy isn’t short of risks and possible side effects. Some of the most common risks and possible side effects include:

What to expect during a marginal mandibulectomy?

Before the procedure

You will be given specific instructions regarding what to do before the surgery. Some of the instructions include:

  • You should not eat or drink anything for 6 hours before the surgery.
  • Avoid using blood thinners, such as Warfarin or Aspirin, a week before the surgery.
  • Refrain from smoking before the procedure.

You can also expect the following things:

During the procedure

You will be given general anesthesia and made to sleep throughout the procedure. The physician performs marginal mandibulectomy by:

  • Making an incision at the affected side of the lower lip or cheek
  • Removing the tumor and the surrounding soft tissues
  • Preserving the inferior border of the jawline to retain the bone strength for chewing
  • Closing the incisions

After the procedure

You can expect the following after the surgery:

  • Pain and numbness in the lip or chin
  • Wired jaw to keep the upper and lower teeth aligned
  • Getting pain medications for pain relief
  • Returning to home after 2 days in the hospital
  • Undergoing physical therapy or speech and swallowing therapy after surgery

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References
Varvares MA. Mandibulectomy Periprocedural Care. Medscape. https://emedicine.medscape.com/article/1890889-periprocedure#b6

THANC Foundation. Mandibulectomy. https://thancguide.org/cancer-basics/treatments/surgery/ablative/mandibulectomy/

OncoLink. Surgical Procedures: Mandibulectomy. https://www.oncolink.org/cancers/head-and-neck/treatments/surgical-treatments/mandibulectomy

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