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Oncologists and Surgeons at Jaypee Hospital, Noida have performed a marathon 9 hour surgery to remove a rare and complex cancer of the mouth...

Oncologists and Surgeons at Jaypee Hospital, Noida have performed a marathon 9 hour surgery to remove a rare and complex cancer of the mouth and reconstruct the lost jaw bone in a 57 year old patient.

The patient, who had a habit of chewing tobacco, developed a cancerous ulcer on the floor of the mouth, known as coffin’s area of the oral cavity. He needed immediate surgical intervention to survive the cancer scare.

Doctors at the Department of Oncology joined hands with Plastic Surgeons at Jaypee Hospital to perform a rare and complex procedure on the patient, who is now on road to recovery.

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Dr. Pawan Gupta, Associate Director, Surgical Oncology, Jaypee Hospital,said: “The patient, a resident of Reva, was found to have cancer of the lateral floor of mouth. He was operated upon by a team of doctors who removed the left side of the jaw bone, the floor of mouth, a part of the tongue and neck nodes to get rid of the cancer”.

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The surgery that commenced at 10 a.m, ended around 7 p.m and was completed successfully with contribution from a team of oncology surgeons and plastic surgeons. Once the cancerous parts were removed, the procedure required reconstruction of the lost areas.

Four senior surgeons were part of the team that performed the surgery. Reconstruction was done with micro vascular free flap from the leg bone for making the jaw bone and soft tissue by Dr. Ashish Rai (Senior Consultant, Plastic, Aesthetic & Reconstruction Surgery), Dr. Ashutosh Mishra (Executive Consultant) and Dr. Saurabh K.Gupta (Associate Consultant).

“The patient was referred to me by his friend whom I had helped quit tobacco. On a casual examination I could not notice anything except for some sub mucosal fibrosis affecting the buccal mucosa because of long tobacco use. Then I noticed it, there it was hidden by the tongue – between the tongue and inner side of jaw bone was a deep ulcer in the lateral floor of mouth- what we call as coffin’s area of oral cavity,”

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said Dr. Gupta.

Cancer of the Coffin’s area of the oral cavity is not so common cancer for tobacco users who keep the quid for long hours in the mouth. The anterior floor of mouth cancer is more common. This is why sometimes this type of cancer is overlooked by doctors examining the oral cavity. This ulcer is quiet often missed on a casual examination of oral cavity thus the name – Coffin.

However, while examining the oral cavity one should not miss to examine this area. It can be done by just retracting the tongue medially by a spatula/spoon.