I have just returned from Miami where I underwent my second surgery for osteosarcoma of the mandible. The first surgery, last December, was for a mandibulectomy to resect the cancer with temporary reconstruction with a titanium plate to keep my jaw in place. The skin to cover the plate was obtained from my back and left attached to my trapeazius muscle so it would have a blood supply. Needless to say I had a very irregular appearance for the past nine months. Also, with only four bottom teeth, I was limited mainly to drinking.

Last week I reported to Miami and Dr. Marx again where some bone from my left hip, some stem cells from my right hip and some bone morphogenic protein from a cadaver (cow or human, not sure) were, in a 12 hour surgery, placed where my mandible used to be. All held in place in with collogen sponges and titanium mesh. The swelling caused by the additional protein in my face is astounding but should subside in about a month. Also, my jaw is currently wired shut for the next month so the initial bone growth goes undisturbed. For now I am drinking what I can and supplementing with the PEG. By March this bone mixture should have knitted together into a mandible strong enough to support some implants, and in a few more months after that, teeth.

My defect (where my jaw used to be) was 9cm. It went from my TMJ on the left about 2/3 of the way to the right TMJ. I was left with four native teeth on the right. I asked Dr. Marx if this was a large span for him to cover and he replied that I did even not qualify as a challenging case and that he'd spanned much bigger defects than mine successfully.

For those of you who are living without much or any of their original mandible it may be worth a call to Dr. Robert Marx at the University of Miami Department of oral surgery. He is one of the top five people in the world for this type of bone replacement and performed much of the pioneering work in this field. The Marx protocol of hyperbaric oxygen therapy bears his name and is standard of care for osteoradionecrosis patients.

Please write with questions as, according to Christine, I'm the first on this forum to be perusing this line of treatment and I would be happy to help in any way that I can.

Already I can see that my lower lip and chin no longer collapses inward as now there is bone behind them. Once the facial swelling goes down I know that I'll be pleased with the improvement of appearance.

So glad you did well. Heal up - I'm sure there are lots of questions. Take care.

Thanks Richard for being a pioneer. I have had three massive doses of radiation to my right jaw and still suffer deep pain there. We are in a wait and see mode on whether the jaw will survive. Every day that passes with less pain and jaw still intact is a good one but my Dr. said it could be up to three years before we know. I may need a replacement jaw sometine in the future so its great to have folks on the board who have had all the different reconstructions including your new procedure.

I'll be watching for your updates.

Richard, I am so glad to read your update!!!! Thank you for coming back and checking in. I wish you a successful, pain free recovery and hope this surgery is a success. Its amazing the things that can be done. Be well!!! You are one lucky guy!!!!

Richard, you're my new hero. Can't imagine what you've been through and are still enduring but you are one amazing guy. Miami is my hometown and I'm glad to read about such a wonderful surgeon there.

I think I speak for everyone here in congratulating you, and I'll continue to send good thoughts your way.

[quote=ChristineB] You are one lucky guy!!!! [/quote]

Don't I know it.

Thanks.