free flap reconstruction of gums

Hi there,

I had a left forearm free flap reconstruction on my tongue back in 2012. I believe it’s very common. It helps with speech, eating, and swallowing.

So, Lynda, I would say you went through a difficult procedure or possibly multiple procedures.

So you had cancer of the gums and then it spread to the jaw bone and in the meantime of waiting for surgery for the previously found gum and jaw cancer, the cancer spread to a lymph node which was discovered among the 30 lymph nodes later removed.

So I have a couple of questions.

Did you have any follow-up radiation and or chemotherapy for either lymph nodes or the cancer in your mouth?

What area of the mouth was this issue in, top or bottom, right or left?

How did they deal with the cancer in your bone was it scraped or removed by surgery and or was there a bone graft or replacement?

At any point was the cancer in your bone considered or referred to as Osteoradionecrosis?

So they removed all the teeth on the one side of your jaw, then is this where the free flap was done?

When doing the free flap could they just use the excess gum material after extraction to fold it over from both sides of your extraction area and make a flap that way or was it necessary to remove tissue from another part of your body to use in your mouth to cover the opening from the extractions and bone cancer thus making a free flap this way?

I am asking these questions to learn and be clear on your experience so that it may help others.

Wishing You The Best

Take Care, God Bless

Russ

NEGU (Never Ever Give Up)

Lynda, that was a very good explanation I understand now.

You went through quite a major situation and operation.

This is no small feat to accomplish this and endure what you went through.

And not only bone replacement but a titanium plate also.

I am glad for you that you are able to get some liquids down already and are testing small bits of food.

I am with you on the coffee, it seems no matter what I went through in my 3 cancers, in recovery I was always glad for that first cup of coffee and could taste it and for some reason, it gave me such comfort and a reprieve away from what I was going through for a short bit.

As you go along the days will get better and you will get recovered and with H&N cancer and radiation it is not a quick process but a sure process, be patient.

Take Care, God Bless,

Wishing You The Very Best

(NEGU) Never Ever Give Up

I had a free flap reconstruction from my left arm for a tumor under my tongue that grew into my jawbone.

I had a flap done in February of this year 2024. I was in the hospital for 13 days. I had a malignant tumor that was in my right sinus cavity and it invaded my right upper jawbone, orbital bone, and teeth. Doctors removed my entire upper palate, 5 jaw teeth, and ground, or rather cut as much of my jawbone off with causing brain infection up to my orbital bone. They took part of my wrist and arm, along with the artery to make a new upper palate. I spent 6 weeks in radiation therapy. I have lockjaw due to the surgery and having my mouth held open for 10 hours. It took 6 hours for the surgery I went into recovery, where alarms went off of a possible heart attack due to a blood clot in the artery they used from my arm. I went back to surgery for 4 hours. It has been a bumpy ride. But I have great Ear, Nose, and Throat Specialists and a wonderful Radiation Oncologist. I will be monitored with rotating MRI's and CT scans every 3 months for the next 5 years.

I haven't had any pain at all from the surgery. I feel and sound like I have a mouth full of mud, though. LOL.

I'm sorry, I have a tendency to make jokes at the wrong time. I think its just a coping mechanism. If you haven't had to go through any radiation, bless your soul. The radiation, every day for 6 weeks, tore my mouth up. Other than that, I have what they call phantom pains where my jaw teeth used to be. Its not real bad pain though. One thing I do know is, don't trust your tongue. My tongue flops around feeling of that new flap, and I have worried myself to death over it, thinking it was going to come apart, that I had metal under it, that they left pieces of teeth in there, etc. I'm telling you, I just had to say "stop it". Part of my neck where they cut muscle and tendon in half to get to the blood clot, is still numb after 7 months. Half of my tongue is still numb also. The doctors said that I will be numb for maybe a year or more until the nerves start waking up again. The side of the head, the jaw, the carotid artery area, my shoulder muscle, and my upper arm are all connected by tendons, muscles, and nerves. When I wash my hair I can feel my neck tingling. Its so weird.

I am able to eat and swallow. That was the hard part. I had to take it super slow. I was on liquid diet for over a month. Then pudding, milk shakes, etc. while on radiation. The doctors told me to put tongue depressors in my mouth on the side that has teeth at top and bottom. I put one in, let my jaw relax and add another one. I have had up to 7 or 8 in there and my mouth is slowly opening working like its supposed to. I'm not completely the same but I AM GOING TO GET THERE. I'm 7 months out and the lock jaw is what is making me aggravated. I saw a Maxillofacial Surgeon last week. He told me he could take out the radiation damaged muscle and replace it with tissue from my leg. He could only give me a 50/50 chance of it working and a 50/50 chance that I wouldn't heal and it would get infected causing other body parts to be harvested for bone to replace the jawbone in the event that it got infected. Plus he told me I would NEVER be able to open my mouth more than 2 finger widths, with surgery that was successful. I said "No Thanks". Here's my secret though….my chiropractor has gotten my jaw moving and my mouth to open 2 finger widths already.

Please don't give up on getting better. This is what I live by before and after I had surgery:

Do what you gotta do until you can do better. Refuse to give up and if someone tells you that you can't or won't, blah, blah, blah! You tell yourself you can. I'm stubborn and I'm getting there. You are still in the neck of the woods where you may choke a little, when swallowing. Just go slow. I can't drink anything and put my head down. It comes right out of my nose! My grandsons were sitting at the table one day and I took a drink of milk. It shot right out my nose and they laughed until their bellies hurt. I did too. Some things you just gotta laugh at because there isn't anything you can do about it except TAKE IT SLOW. Keep me updated on your progress. I know you're gonna make it there.

I'm 57 years old and this is me pre-surgery. I look exactly the same with the exception of the neck scar, trachea scar, and arm scar where they took the flesh and artery to rebuild my upper palate. Please don't get discouraged. If you do, think of something to tell yourself to make you keep trying and say it over and over. Every day, I get on Facebook and put up a good morning hello to those that have access to my page. I do it, because I am so thankful I have scars to look at. I'm thankful that my doctors used my body to save me. I want everyone to know that I am wishing them a great day, because I know I'm going to have one.