Webcast to examine innovative palate reconstruction

April 17, 2006
Procedure to remove oral cancer will be featured in a webcast at 5 p.m. May 16.

WINSTON-SALEM, N.C.--Patients undergoing surgery for removal of cancer from the mouth often have large openings in the palate (roof of the mouth) where the cancer had been, leaving them unable to eat, drink or speak normally unless the defect is somehow repaired.

One solution is the surgical reassignment of a muscle normally used for chewing to fill the space left in the palate, a procedure that has been advanced at Wake Forest University Baptist Medical Center and has produced excellent results for head and neck cancer patients.

The procedure will be featured in a live webcast at 5 p.m. May 16.

Having done 400 major head and neck reconstruction procedures over the past decade, J. Dale Browne, M.D., a professor of otolaryngology, is one of the region's leading experts in both the microvascular replacement of bone and soft tissue and the use of the temporalis muscle for palate repair.

Although he didn't invent it, Browne has developed the use of the temporalis muscle to rebuild the palate following removal of palatal and nearby malignancies, and is one of the few surgeons in the country doing it routinely.

Many surgeons who treat these problems rely on a prosthetic device such as a modified denture that fills the defect created by the removal of the tumor. This approach presents multiple concerns, including repeated remodeling of the device to achieve a satisfactory fit.

The temporalis muscle reassignment, however, is done as part of the initial surgery and can provide superior results. In a paper published in Archives of Otolaryngology Head and Neck Surgery, Browne reported that 15 of 16 patients studied were able to resume their preoperative diets, with no speech problems and no need for repeated surgical intervention. Browne has since performed more than 60 of these procedures and continues to see positive results.

During the webcast May 16, Browne will perform a cancer removal and reconstruction using the temporalis muscle, and Chris Sullivan, M.D., will serve as co-host. Browne and Sullivan are the surgical arm of the Multidisciplinary Head and Neck Tumor Clinic at Wake Forest Baptist.

The ability to have both the cancer removal and reconstruction of the defect at the same time is a major benefit for the patient. For example, Browne recalled one patient who had a salivary tumor. To remove the tumor, Browne had to remove about half of the patient's hard palate, part of the soft palate as well as some teeth.

Following the removal of the tumor, Browne transferred the patient's temporalis muscle into her mouth and used it to reconstruct her hard and soft palate. The new palate healed uneventfully and functions normally. She remains free of cancer years later.

In addition to the temporalis-palate procedure, common reconstructions performed by Browne involve the transfer of donor replacement tissue along with its artery and vein. Such procedures commonly involve the use of bone and tissue from other parts of the body, including the hip, lower leg, wrist and forearm.

The webcast will be available to the general public as well as physicians, oral surgeons, dentists and other medical professionals. All live webcasts are also archived for viewing later.

To register for a reminder e-mail, or to view the webcast, go to www.wfubmc.edu .