Johnnie,

My wife had same type of swelling on the right side of the face on several occassions starting in 2010 or about 5 years after the end of the treatments. She had multiple MRI which were inconclusive. She saw an infectious disease specialist who pescribed 20 HBO treatment and port to connect a pump for antibiotices. She had the port and the pump for three months. After the HBO treatments and the 3 month long of antibiotics the swelling stopped but she still had pain on the right side. We went to go see and a maxillofacial dentist who did a Panorex which clearly showed a fracture on the lower jaw on the right side due to ORN. The right side frcature was stable though with no pain. In late 2015 she started havng pain on the left side of the lower jaw. Again we saw our ent and other surgeon and she had multiple MRI which were inconclusive. In October 2016, we went to go see the same maxillofacial dentist. He did another Panorex which showed another fracture of the left lower jaw. She was in pain constantly due to the left fracture. After seeing three surgenons/ENts at the USC Norris Cancer Center and also gettting a second opinion at the Stanford Medical Ceter we reluctantly decided in the full replacement of the lower mantible by a fibula free flap from the left leg. The fibula was removed along with tissue and blood vessel. The lower jaw was fully removed and then reconstructed using the transplant from the leg. The bllod vessel from the leg was sutered to the blodd vessel in the head to re-establish blood floow to the lower transplated jaw bone. The surgery was 10 hours long. Post surgery, because the tongue had to be released and the flap is really bulk, the tongue was pushed to the back of the throat and she could not longer eat or speak clearly. She has been on a J-tube since. The surgery is radical and witl post morbididty. At the Stanford Medica Center we were given the otion to reconstrcut the left lower jaw using a flap from the right and to place a titanium plate over the right jaw fracture. This was they would be able to save the chin and also the surgeon would not need to release the tongue. Our three surgeons/ENT at USC Norris whom we had seen and known for 10 years were advocating the fibula free flap from the leg. We went with the fibula free flap but revovery time was about a year and left the wife with the inability to eat or speak clearly.