In May of 2003,my husband had cancer of the oral cavity and mandible and anterior floor of mouth on his right side. He had a full flap operation where he had his mandible replaced with a bone from his leg and muscle for the floor of his mouth. He lost half his teeth. He came home in four days from the hospital with a feeding tube and a cast on his leg. He actually felt fine. I forgot how long he had the feeding tube in, I think it was for about 6 weeks.

About a month and a half later he started his 33 sessions of radiation. Then he had all kinds of
problems from the radiation. About 8 weeks after his radiation sessions, his face swelled up with edema and it actually "blew" out about 4 inches of his scar. It took a long while for the edema to subside. Then he had a fistula that his doctor was worried about. He then had to go back on a feeding tube for almost 3 months. The fistula still wasn't completely healed to the doctor prescribed 30 sessions of hyperbaric oxygen sessions, the he had to go for another 20 sessions. It finally went away. He also has a "hole" in his scar where the edema blew out and it has crystalization coming out.

His last visit to the plastic surgeon at Loyola University said he still had a little puss in his mouth and the hole in his scar,


and is very concerned that it may an infection where the bone is fusing. All the dental scans don't really show anything because of all the hardware in his lower jaw. If it was up the the doctor he would have my husband have another full flap surgery and remove the hardware, but husband isn't going for it. So now the doctor told him see what his dentist says when he goes for implants.

He is now going to an oral surgeon and the surgeon is also concerned about the puss. He has recommeded my husband to have a couple of doctors at University of Chicago see him (counterparts of his from Loyola) to have a second opinion. Plus he has one tooth pulled from the other side of his mouth and its taking a long time to heal, it was full of puss when he pulled it. He still has to have another one pulled but oral surgeon won't do it until this tooth is healed completely.

Has anyone here had this type of operation and if so did you have tooth implants?

There are bigger issues that MUST be addressed right now that supercede the consideration of implants. There is an infectious process at play here. This HAS to be brought under control. There is a risk of losing all the work that has occurred reconstructivly to this point if it is allowed to prosper. I am appalled that the doctors that you are talking to are not more concerned about this. You need a second opinion from a head and neck surgeon as to what is going on and an appropriate course of action forward from this point. Your husband likely needs to be on some aggressive antibiotic treatment at minimum, and perhaps needs surgical intervention if the infection has involved the implants holding the osseous reconstruction together. An extraction after radiation was a risky venture ,and that there was infection involved at that site and not addressed seems grossly out of order. I do not wish to alarm you with this post, but none of these post 02 treatments feels like it was handled well. While you say that your husband is disinclined to redo things, or have additional surgery to fix what is obviously wrong... he needs to get his head around the fact that something is wrong that needs to be fixed, it is not going away on its own, and it is unlikely that his body is going to bring this under control on its own.

What you say is true. The original plastic surgeon is very concerned and has been all along but my husband keeps refusing another operation!!
Yes he is bull headed and maybe by seeing another set of doctors at another hospital will force the issue. At least the oral surgeon gave him antibotics!!

I think that our original doctor wanted him to see an oral surgeon to let my husband know that this infection is not good!! I guess we will know more in May. I will keep you posted!

Thank you for responding...

Time is of the essence. This is nothing to fool around with. Massive infections around reconstructions can cause the lose of the entire reconstructed area. Late treatments are always a worse senario, as more tissues are damaged and lost. Even with surgery, if done at a late date, it might leave your husband in worse condition than he finds himself today. Delay is bad, and he needs to realize this soon so that he will pursue suitable treatment. Would it be depressing to go tback into surgery? You betcha...but would it be worse to not be able to save the reconstruction and endure months of unreconstructed healing mandible before this could all be tried again? Definitley.

Brian,
Just to let you know the update of my husband. We just got a second opinion from U of Chicago and they concur with our original dr at Loyola, to remove the hardware and clear up the infection before starting on the implants. His oral surgeon won't touch anything either until the infection is cleared.(Their opinion is that the hardware is rubbing into his tissue (they even took an tissue sample). They will also write a letter to our original dr. From their opinion it would only take about an hour to take out the hardware.

So we will go back to Loyola and discuss this with the dr and hopefully make arrangements to have the hardware taken out. Thank God my husband has made up his mind to go ahead with it.
All the drs have told us if he doesn't do anything the infection could deteriorate the bone in the long run then it would be another major surgery.

Thank you again for your input. Will keep you up to date.

I can't add much to what Brian has stated Lila,.
Time is precious in this type of situation!! Try and move everything up as soon as possible. Yell, Hollar and rant and rave. He needs attention NOW!!

Bad enough as it is to go through this without the problems he's facing. Can't imagine what your Husband is experiencing. I'll be sending good vibes your way as his situation is resolved.
Remember Lila, "This to Shall Pass"

All my Best, Danny Boy

Hi,
I second Danny's and Brian's opinion to have this taken care ASAP. I would have done it in Chicago while I was there if at all possible. Do not delay.

Take care,
Eileen