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Surgeons at Perlmutter Cancer Center are experts at reconstructing the upper and lower jawbone in people with head and neck cancer. Before surgery, our specialists use CT scan images of the tumor and jaw to create three-dimensional, computer-generated models of the areas to be reconstructed. Surgeons use these models to create templates, which guide the incisions needed to remove the cancerous jawbone and construct the new jaw in the same shape.

To rebuild the jaw, doctors may use the fibula, a bone from the lower leg. Other bones in the face can also be reconstructed. For example, the cheekbones, eye sockets, or the palate (the roof of the mouth) can be replaced with bones from other parts of the body, such as the fibula, forearm, or scapula (the shoulder blade). Doctors ensure that the procedure doesn’t create a disability in the area the bone is taken from, called the donor site.

Reconstructive surgeons can also repair soft tissue—parts of the tongue, throat, or lips—removed during surgery. Sometimes small areas of soft tissue removed from the head and neck can be replaced with nearby healthy tissue, called a flap, which is still attached to its own blood supply. Flaps with their own blood supply heal quickly. They may come from the scalp, cheek, forehead, neck, or chest.

Often, flap tissue is taken from a distant part of the body. Forearm skin may be removed with its blood vessel supply to replace a missing portion of the tongue so it can be used for speech and swallowing. The flap’s blood vessels are then carefully attached to vessels in the neck at the site of repair to restore blood flow.

Surgeons may also use other tissue, such as cartilage from the ear, to reconstruct structures such as the nose.

Doctors may use nerve grafts to restore motion or sensation in the head and neck. For example, surgeons can remove a nerve from the leg, where its function isn’t noticeable, and use it to restore facial motion or sensation necessary for proper speech and swallowing.

Recovery from head and neck surgery with reconstruction varies greatly. Minor reconstruction, including flap surgery, may require only two or three days of recuperation in the hospital. In extensive reconstruction, such as removal and replacement of the jaw or a large portion of soft tissue, hospitalization may be longer and recovery at home may take several weeks. If a bone from the leg is removed to reconstruct the jaw, you may need rehabilitation to help with balance and walking.

During this time, our doctors monitor your health and ensure you are healing properly. You may also meet with doctors at Rusk Rehabilitation if you need speech and swallowing therapy.