COIMBATORE:An advanced surgical procedure called as ‘segmental mandibulectomy’ was performed on a eight-year-old boy to remove a rare, malignant tumour near his lower jaw by Coimbatore Medical College Hospital doctors.
The boy Y Madesh from Tirupur had developed a swelling near the right mandible (lower jawbone). His father, Yogabalan, a painter took him to the IRT Medical College Hospital in Perundurai and results of the Free Needle Aspiration Cytology (FNAC) test suggested that the boy had developed a cystic lesion in the zone.
He was referred to the Coimbatore Medical College Hospital for treatment. A rare jaw tumour (ameloblastome) that was growing rapidly was spotted in the MRI scan reports and juvenile ossifying fibroma was identified using the open-biopsy. This locally malignant tumour was growing rapidly and before surgery, the disease has affected the entire right jaw from the mandibular condyle to the jawline for 15 cm.
This condition, which is common among adults is very rare among children as only one in a lakh children below the age of 10 years get affected by it.
The segmental mandibulectomy surgery was performed by Dr B Asokan, Head of the plastic Surgery Department.
Dr Asokan said that since the tumour was close to the condyle, facial nerve and salivary glands, the risk factor was always high and without proper expertise, the patient might have difficulties in closing his eyes and his face disfigured.
In the procedure for adults, fibula free flap approach is adopted in general for reconstruction of mandible.
But in children, this is not advisable since the calf bones (fibula) is still developing, making the reconstruction process difficult.
So with great care, the mandibulectomy was done to remove the tumour and post-operative care was given to maintain the normal occlusion (arrangement of teeth and their supporting structure) and keep the glands in tact.
Dr Asokan said that the cost of this surgery would be around `4 lakh in a private hospital, and was performed under Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS).