Replacing missing jaw bone removed during tumor surgery is important to restore the facial profile, maintain chewing ability, and to provide a platform for new teeth. There are multiple options to replace missing bone. Some methods are possible at the same time as tumor removal, and other options must be delayed a few months.
Immediate replacement of bone is most predictable with a vascularized bone transplant from another area of the body. This is most commonly done with the fibula from the leg. The fibula is harvested with the blood vessels supplying the bone and re-attached to vessels in the neck. Because this bone has it's own blood supply, it has a very high survival rate (95%). Most patients do surprisingly well giving up this small bone because the larger bone (the tibia) remains. Dr. Williams'team has performed this surgery on a marathon runner, a cyclist, and a power lifter who continue their sports. While there is never a guarantee that problems will not develop after such a complex surgery, most patients tolerate giving up their fibula quite well. When there is a choice, Dr. Williams prefers to use the LEFT fibula because there is less interference with your driving ability during the early stages of recovery.
Another advantage of the fibula is that soft tissue from the leg (skin) can be taken with the fibula to replace soft tissue in the mouth removed with the tumor.
Immediate replacement of bone is most predictable with a vascularized bone transplant from another area of the body. This is most commonly done with the fibula from the leg.