Jaw reconstruction method for oral cancer shows promise in animals - 2 patients

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Jaw reconstruction method for oral cancer shows promise in animals
Anthony J. Brown, MD
Reuters Health

Last Updated: 2006-06-29 9:35:55 -0400 (Reuters Health)

NEW YORK (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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