New Delhi/Kolkata: Manipal Hospitals Whitefield, Bangalore has added another feather of success to its cap with a rare bone tumour surgery during lockdown. A multi-disciplinary team of surgical oncologist and plastic reconstructive surgeons successfully managed a case of recurrent Ameloblastoma of a patient from West Bengal.
This was possible by an appropriate and timely treatment by a team of experts of Manipal Hospitals Whitefield, Bangalore. The fear of COVID 19 and distance between West Bengal and Karnataka did not stop the patient from getting the critical surgery done at Manipal Hospitals Whitefield.
A 42-year old patient from West Bengal went to the Manipal Hospitals, Whitefield with severe jaw pain and swelling during the lockdown. Due to the large tumour size involving the entire jaw he had difficulty in chewing, swallowing or talking. CT scan showed a very large multicentric expansile lesion destroying the jaw bone at 3 places. Biopsy revealed it was a rare tumour called Ameloblastoma, notorious for being locally aggressive and recurrences.
Surgery is usually the first-line management in such tumours and failure to remove the tumour completely is associated with high chances of recurrence. In this case, too, the patient had undergone surgery twice at his native place, but developed recurrence. He finally reached out to the Manipal Hospitals, to seek expert opinion and care, unable to bear his severe jaw pain and worsening condition.
Dr. Ashwin Rajagopal, Consultant, Surgical Oncologist, Manipal Hospitals Whitefield said, “He was successfully operated by a multi-disciplinary team of surgical oncologist and plastic reconstructive surgeons. About 90% of the jawline at one-side had to be removed, as his entire jaw was involved with tumours. It took almost 4 hours to complete the surgery.”
Dr. Rajagopal said, “Ameloblastoma, though benign, has a high recurrence rate. It keeps growing and can destroy the bones in the affected area extensively, if not removed completely. A pathologist often examines the rim of the tissue during the surgery, to ensure all the tumour cells have been completely removed, a procedure known as surgical margin. Achieving radical resection of bone and floor of mouth muscles with negative oncological margins was paramount to prevent another recurrence. I wanted to be 100% sure that the entire tumour has been removed.”
Highlighting the importance of seeking appropriate medical management for serious conditions during the ongoing pandemic, Dr. Ashwin Rajagopal added, “One cannot wait for surgeries like this. Such patients need immediate medical attention and treatment to prevent complications.”
Dr. Ramani CV, Consultant, Plastic, Reconstructive and Cosmetic Surgery at Manipal Hospitals Whitefield, said, “But only a part of the problem was solved. The patient also required a major jawline reconstruction surgery to aid swallowing and speech. This complicated plastic reconstruction surgery lasting over 8 hours involved removing his femur bone, reshaping it to match the jaw and fixing the same at the jawline.”
He said, “It was a challenge in managing recurrent ameloblastoma to achieve complete removal and reconstruction, especially when the tumour is extensive. Creation of new jaw bone was tough since we had to restore both aesthetics of face as well as the function of the jaw so that he can chew, swallow food and talk normally.”
Dr. Sunil Kumar, Consultant, Plastic Reconstructive and Cosmetic Surgery, Manipal Hospitals Whitefield said, “The patient has recovered well after the surgery. Post physical rehabilitative therapy for mastication and speech function he is leading a normal life.”
This is not the first time that patients from Eastern-North Eastern parts of the country have went to South, mainly Bangalore when it comes to critical surgeries.