Advancements in Oral and Maxillofacial Surgery: Dr. Marwan's Latest Research Findings

Sep 14, 2023, 09:50 AM by Melanie Connolly

Two significant research contributions from Hisham Marwan, DDS, FACS, Chief of Oral and Maxillofacial Surgery, offer promising advancements for our field and potential enhancements to clinical approaches. 

In partnership with the OMS Nerve Research Collaborative (OMSNRC), the study investigates the impact of immediate long-span nerve allograft reconstruction on patients undergoing mandibular operations involving trigeminal nerve transection. The primary focus was the reduction of chronic postsurgical pain (CPSP) and prevention of posttraumatic trigeminal neuropathic pain (PTTNp) following surgery. 

This study comprised a retrospective analysis of patients who underwent mandible resection due to benign or malignant diseases. Patients were categorized into groups based on whether they received immediate nerve repair or not. The primary outcome assessed the presence or absence of CPSP and PTTNp at the 6-month post-surgery mark. 

The findings revealed the significant benefit of immediate repair in reducing CPSP and preventing PTTNp. Statistical analysis identified a strong inverse relationship between immediate repair and CPSP/PTTNp incidence. Notably, specific factors such as age, malignant pathology, and chemo/radiation treatments were more frequently observed in the group that did not receive immediate repair. 

This research underscores the potential advantages of considering immediate repair of transected trigeminal nerves during mandibular resection, particularly for cases involving benign and malignant conditions. 

A message from Dr. Marwan:

"This study proved the efficacy and effectiveness of immediate nerve reconstruction after benign and malignant tumor resections. We have more than 100 cases of immediate nerve reconstruction during a jaw in a day procedure and with this collaborative work we collected enough data to have a powerful statistic to confirm our findings. I am very happy and please to serve our patients the best treatment possible and improve their quality of life." 

Dr. Marwan and the research team explored the use of urinary bladder matrix (UBM) in reconstructing avulsed traumatic soft tissue injuries in the maxillofacial region. This retrospective case series introduces an innovative approach to soft tissue reconstruction. 

The study encompassed eight patients with avulsed injuries in different head and neck areas, involving various tissue depths. UBM was employed for reconstruction, yielding remarkable outcomes. Within six months, all eight patients achieved complete healing without the need for additional surgical procedures. The average healing time was remarkably short, at only 36.5 days. 

UBM demonstrates promise by minimizing donor-side morbidity, eliminating contraction issues, and offering versatility in addressing various maxillofacial soft tissue defects through a single-stage procedure. 

Dr. Marwan's recent collaborative research contributions provide valuable insights into potential improvements for patient outcomes and the expansion of surgical options in oral and maxillofacial surgery. 

A message from Dr. Marwan:

"We have been using this material as a skin substitute for small size facial defect. This study showed impressive outcomes for reconstruction of facial defect without having skin graft from another site."

Congratulations, Dr. Marwan!