Health Care Science and Innovation

Life-changing procedure at AdventHealth restores hope for patient with jaw tumor

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Briana Nichols

Briana Nichols was only 18 years old when she felt something was wrong with her jaw when she touched it. She went to the dentist, where they told her it was a cyst. After meeting with a couple of doctors, she was told the cyst could not be removed because of how large it was.

“It was a really stressful journey because I got a lot of, ‘No, try this doctor’ and ‘Never mind, try this doctor,’” said Nichols.

She was losing hope of receiving treatment until she met with Dr. Fawaz Makki, an otolaryngologist at AdventHealth, who told her it was in fact not a cyst, but a benign jaw tumor.

Makki and his team of head and neck surgeons at AdventHealth Altamonte Springs are the first in Florida to provide comprehensive jaw reconstruction surgery outside of an academic setting. The treatment includes dental rehabilitation as well as implants placed on the leg bone to reconstruct the jaw defect. This procedure is also known as jaw reconstruction surgery and it provides patients with the fastest recovery possible, allowing them to return to their normal life activities.

“If I didn’t have this opportunity, it would have led to my jaw being broken and instead losing half of my jaw, it would have been my whole jaw,” said Nichols. “I was 19 and I am still young. I know how society views women in general, so being able to do this surgery is amazing.”

The standard of care is to replace the jawbone with another bone transplant from either the leg or shoulder. However, dental rehabilitation is always an obstacle due to the technical difficulty and the expertise required to achieve a functional reconstruction in one surgery.

During this procedure, Makki and his team cut out the jaw tumor based on prior digital planning. Bone from the fibula is then harvested to reconstruct the jaw. He digitally plans out where the dental implants need to go in the leg bone. The dental implants are titanium screws that get drilled in the bone, and then they get osseointegrated -- the process of bone cells attaching themselves directly to the titanium and locking the implant into the jawbone. When they take that bone and rebuild the jaw, those implants are already lined up where they need to be. This allows the patient to have replacement teeth that exactly fit and line up with the opposing teeth. This is all done in one procedure.

“At the end of the day, we’re not just trying to cut the tumor out and cripple the patient to the point where they cannot eat, drink or socialize,” said Makki. “Right now, we are at the point of trying to get them back to a normal quality of life as much as possible, which is why this procedure is so important.”

Not only was he able to tell Briana that he could remove the tumor, resulting in the removal of three-quarters of her jaw, and rebuild her jaw, but that there was a possibility she could have full teeth rehabilitation of her reconstructed jaw in the same surgery.

Briana underwent jaw reconstruction surgery last August at AdventHealth Altamonte Springs, and was able to recover in time for the holidays.

“I look at old pictures that my mom took and it’s honestly insane to see the difference between my face now and what my face used to look like,” said Nichols. “It was an insane journey and it’s even crazier that it was less than a year ago.”

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