Photo By Petty Officer 2nd Class Jacob L. Greenberg | 201229-N-DA693-1004 SAN DIEGO (Dec. 29, 2020) A patient’s prosthetic denture and...... read more read more
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SAN DIEGO – Surgeons assigned to Naval Medical Center San Diego (NMCSD) performed the Department of Defense’s (DOD) and California’s first ever immediate, jaw reconstruction surgery with 3D-printed teeth Nov. 18, and approximately six weeks later, the patient is well on his way to a full recovery.
Marine Corps Lance Cpl. Jaden Murry, assigned to Combat Logistics Battalion 7 at Marine Corps Air Ground Combat Center, Twentynine Palms, Calif., had nearly his entire tumor-stricken lower jaw removed and reconstructed with a segment from his fibula, the smaller of the two lower leg bones, in a novel procedure.
It was approximately one year since first being diagnosed to being admitted into NMCSD’s pre-operative room for surgery.
“To be honest, I wasn’t too nervous,” said Murry. “Even though I hadn’t been in a hospital since I was three, I knew I was in good hands. I had to put all of my faith and hopes in the hands of strangers. I had to trust them all.”
Murry’s mother and grandfather played vital roles as both healthcare advocates and beacons of hope.
“My mother called Dr. Odette with questions that I wouldn’t have thought to ask, and my grandfather assured me that everything was going to be alright,” said Murry. “He calmed me down and put my mind at ease. [Odette] and Dr. Hammer have been very good at passing information to me and my family.”
Lt. Justin Odette, one of NMCSD’s Dental Department’s Oral and Maxillofacial Surgery (OMFS) chief residents, and Lt. Cmdr. Daniel Hammer, a maxillofacial surgical oncologist and reconstructive surgeon assigned to NMCSD, were members of the multi-departmental team of surgical specialists who performed Murry’s procedure.
“Everything had gone as planned, and [all of the providers] worked as a team to keep his expeditious recovery on track,” said Hammer. “We were able to safely remove his tracheostomy tube within a week of the surgery, and it was then we knew he was making strides in the right direction.”
A tracheostomy tube is placed into a hole in the patient’s neck to use for breathing when there is concern for the patient’s airway in the post-operative period.
“In addition, one week into [Murry’s] recovery, we performed a swallow study, and he passed with flying colors,” said Hammer.
The swallow study shows what the mouth, throat and top portion of the esophagus do while swallowing. The live, fluoroscopic test uses X-rays, so doctors and speech pathologists can watch the swallowing mechanisms in real time.
“Since his surgery, [OMFS specialists and I] see Jaden twice weekly for check-ups, and we’re guiding his healing process,” said Hammer. “To see him swallowing, speaking, walking and not using a tracheostomy tube one week post-surgery was a huge victory, both for [Murry] and for us. Even with an entirely new lower jaw, we were so confident in his ability to swallow, we removed his feeding tube immediately after [Murry] passed the swallow study.”
With a tracheostomy tube in place, speaking is impossible because the air used for speaking escapes through the hole in the neck, and doesn’t pass through the vocal cords. To have Murry speak for the first time after surgery, the providers capped the tracheostomy tube, so air would go up his vocal cords.
“It was weird to hear my own voice, said Murry. “I just made a sound and everyone there cheered. My grandfather made me try to say my ABCs.”
Murry has been stationed with the Wounded Warrior Battalion during his recovery at NMCSD.
“The first two weeks were difficult, and I was in a lot of pain,” said Murry. “I’ve been on a soft food diet of chicken noodle soup, baked beans and ramen noodles. I really look forward to getting back into a healthy mindset and working out, running and body building.”
Murry acknowledged that some parts of the recovery and rehabilitation process hurt, but it’s for the better and trusted his surgical team.
“Everything is going to heal, and healing is a process that won’t last forever,” said Murry.
Hammer said Murry is well on his road to recovery.
“He gets his boot removed today, and I’m clearing him for physical activity,” said Hammer. “He’s a young Marine. [The ability to] exercise and move around is huge for his readiness, rehabilitation and morale.”
Hammer said that a maxillofacial reconstructive surgery five to 10 years ago would’ve yielded a much different result.
“The actual surgical time and associated recovery time was previously measured in years,” said Hammer. “During my training at Walter Reed National Military Medical Center, I treated many wounded warrior cases of service members being injured during the second surge in Afghanistan. These cases would require multiple surgeries over the course of a few years, and the service member might’ve been separated afterward. The impact on the unit, in terms of time away during surgery and recovery, was massive. Our comprehensive jaw reconstruction in one surgery is getting Murry back to his unit, life and family as quickly and as healthy as possible. In terms of actual downtime away from his unit, we’re expecting Murry to be out for only eight to 10 weeks, compared to years with the previous reconstructive techniques. That’s a tiny amount of time when compared to the magnitude of the procedure.”
Hammer said Murry will meet with Cmdr. Yu Zhang, a maxillofacial prosthodontist assigned to NMCSD, to get his final set of dentures, in approximately two months.
“[Murry] will still have regular check-ups with [OMFS staff] to make sure the teeth are in good condition, and he’ll have a CT scan to make sure the new bone is completely integrated into the jaw,” said Hammer. “Providing everything has healed as expected, I’ll have no restrictions in regard to what he can do. Our goal [for Murry] is to have no activity or diet restrictions by six months after surgery, and he is on track to reach that goal.”
Once Murry has his final prosthesis installed, he’ll be able to resume life as normal, which includes eating solid foods. Without hesitation, Murry said pizza will be on the menu that day.
Information and photos about the original surgery can be found at dvidshub.net/news/383704/nmcsd-surgeons-perform-dods-califs-first-ever-immediate-jaw-reconstruction-with-3d-printed-teeth
NMCSD’s mission is to prepare service members to deploy in support of operational forces, deliver high quality healthcare services and shape the future of military medicine through education, training and research. NMCSD employs more than 6,000 active duty military personnel, civilians and contractors in Southern California to provide patients with world-class care anytime, anywhere.
Visit navy.mil or facebook.com/NMCSD for more information.
| Date Taken: | 12.29.2020 |
| Date Posted: | 01.03.2021 11:58 |
| Story ID: | 386246 |
| Location: | SAN DIEGO, CA, US |
| Web Views: | 978 |
| Downloads: | 1 |
This work, Following Up with DOD’s, Calif.’s First Ever Immediate Jaw Reconstruction with 3D-printed Teeth Patient, by PO2 Jacob L. Greenberg, identified by DVIDS, must comply with the restrictions shown on https://www.dvidshub.net/about/copyright.
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