Facial & Oral Cancer Surgery

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Facial & Oral Cancer Surgery

Cancer in the face and mouth can arise from the face, the jaws, the lips, the tongue, the floor of mouth, the cheeks, the palate and the maxillary sinus. Benign tumors such as ameloblastoma is quite a common presentation in the local oral and maxillofacial surgery clinic. Squamous cell carcinoma of the mouth is the most common oral cancer in Singapore. Risk factors include tobacco usage eg betel nut chewing and recent association with the human papilloma virus and possibly oral sex.

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Management of orofacial cancer is a highly specialised field which involves multidisciplinary care and patients should seek treatment from qualified surgeons whose background included training in this area and current with head and neck practice. There are 2 main type of surgeons who practices head and neck surgery, namely oral & maxillofacial surgeons and ENT surgeons. Oral cancers are mainly treated only by Oral & Maxillofacial surgeons who are medically qualified and ENT surgeons also treat throat cancers.

Neck Dissection / Reconstructive Micro-vascular Surgery

Cancer is a deadly disease and the treatment planning is of the utmost importance as it determines the survival of patients. Often oral cancer treatment involves surgery as it is an effective way to remove the disease especially at the early stage. Patients with more advanced disease that has spread will need radiotherapy and even chemotherapy to prevent recurrence, ie cancer coming back.

The surgical treatment involves excision of the cancer and a neck dissection operation to control local and regional spread of oral cancer which is an important part of surgery. After removal of the cancer, there is sometimes a need to use tissues from another part of the body to reconstruct the defect. Technology has enabled reconstructive surgery to be simplified with 3D modelling and planning of surgery and our clinic may be the first private clinic to have used the technology for planning and reconstruction of the lower jaw.

Lower left jaw cancer and leg bone 3D models with computerised planning for reconstruction

Reconstruction of jaw using legbone and dental implants planned with 3D computer imaging

  Reconstructive microvascular surgery such as use of the vascularised radial forearm free flap and the fibula osteocutaneous free flap are important reconstructive options for surgical treatment of orofacial cancers.

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Dr Victor Fan
BDS (Singapore)
FDSRCS (England)
FRCS (England)
FRCS (Intercollegiate)  

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