An oral cancer diagnosis can be overwhelming, but a skilled surgeon with specialized training can provide the expert care needed to safely and effectively remove the tumor.
What UTMB’s Oral and Maxillofacial Surgery (OMFS) team provides is an above-and-beyond solution for these cancers. The team not only removes the cancer in the jawbone but also reconstructs the entire structure of the jaw in a single session, termed “Jaw in a Day.”
“The jaw not only has bone, but also teeth and nerves. The purpose of the procedure is to restore all of the structure at once,” says Hisham A. Marwan, DDS, FACS, Chief of the Division of OMFS in UTMB’s Department of Surgery.
Dr. Marwan explains that prior to these advancements, the surgeon removing the tumor would restore the jawbone, ensuring the patient would heal without a facial deformity. However, this approach did not address the teeth or the nerves.
Now, a single surgery addresses all of these components in six to eight hours, helping to preserve the patient’s physical appearance and quality of life throughout their healing process and beyond.
“The quality of life and normal daily function are restored. We provide them with teeth at the same time, during the surgical procedure itself. This allows them to wake up as ‘normal’ as possible,” Dr. Marwan says.
The procedure also restores sensation to the lower lip, which the patient experiences about four weeks post-surgery.
“When they eat, drink, and kiss, the sensation is there. It is a big, big positive for the patient,” Dr. Marwan says.
The procedure can be performed on both the upper and lower jawbones for benign or malignant conditions.
The approach also allows a cancer patient to proceed with their radiation or chemotherapy treatments uninterrupted. Otherwise, their cancer care may be delayed by the need for additional surgical procedures.
Dr. Marwan says a tremendous amount of planning goes into each procedure. After the patient is diagnosed and the surgeon discusses the care plan with them, the patient undergoes extensive intraoral scanning and a CT scan.
“We send all of that to the biomedical engineers. The surgeon will sit with them, tell them exactly where to plan the cuts and how to restore the jaw,” Dr. Marwan says.
Photos are also taken to ensure proper restoration of the face’s symmetry and positioning of the teeth.
For this surgery, the patient spends about five days in the hospital, with two days in the intensive care unit to manage pain, monitor vital signs, and prevent complications from the bone reconstruction.
After they are discharged, patients begin work with speech therapy on exercises to help regain clear speech patterns, as well as physical therapy on exercises that will improve their range of motion and jaw functionality.
“The best thing is, they are going to resume oral intake immediately. With the teeth there, they can chew their food,” Dr. Marwan says. “We used to have a feeding tube until they recovered, and then they would have to stick with a soft diet because they cannot chew anything without teeth.”
UTMB is the only institution in the Greater Houston area that provides this procedure and is one of only two in Texas. Surgeries take place at the UTMB Galveston Campus, but patients can have their preoperative workup completed in Galveston or League City.
With Dr. Marwan and Dr. Camilo Mosquera performing surgeries, the OMFS team completes an average of two to four Jaw in a Day cases per month and has the capacity to take on more. Because there are so few locations that offer this procedure, UTMB welcomes patients from out of the area.
UTMB’s success rate for these cases has also been exceptional – around 97 percent, exceeding the national average. Dr. Marwan credits the talent and commitment of the OMFS team for the program’s success.
“It is a lot of work, innovation, and technology,” he says. “All the residents, the scrub tech, the nurses, ICU nurses – they know exactly what to do with all of these patients. None of this would be possible without them.”
![]() | Hisham A. Marwan, DDS, FACS, currently sees patients at the UTMB Oral and Maxillofacial Surgery Clinics in League City and Galveston. Learn more about the Division of Oral and Maxillofacial Surgery at UTMB Health. |