Commando Surgery

Commando Surgery (Combined Mandibulectomy and Neck dissection surgery): Oral cancers are common type of cancers that occur as a result of prolonged and consistent tobacco use. Cancers of the oral cavity include tumors of the lip, the larynx, and the hard and the soft palate. Oral cancers are treated with chemotherapy, radiation therapy, and surgery.  Commando Surgery is the surgical treatment of choice for cancers of the tongue, cheek, and the oral cavity. It Comprises complete removal of the tongue and mandibles. The surgery also involves the block dissection of the lymph nodes of the neck.  Commando surgery is effective in annihilating oral tumors. But it also involves removing part of the facial bone and structures, resulting in body image disturbances, Max hospital, India is a pioneer in not only oral and maxillo-facial surgeries but also in reconstructive surgeries that help people change the way they look at themselves. 

Symptoms

There are different stages of cancers, based on the level of their malignancy and the extent of their spread. Some cancers are treated with chemotherapy, whereas some require surgical intervention. The symptoms that predispose the patient for Commando surgery are as follows: 
  1. Persistent mouth sores that do not heal and occur with pain
  2. A lump or thickening in the cheek
  3. A red or white patch at the tongue, gums, tonsil or anywhere in the lining of the mouth sore throat
  4. Difficulty in chewing or swallowing
  5. Numbness in the oral cavity
  6. Swelling in the jaw
  7. Changes in the voice
  8. Pain and loosening in the teeth
  9. Lump in the neck
  10. Bad breath

Medical Test and Diagnosis

The medical tests that help in diagnosing oral cancer are:
  1. Physical Examination: The doctor first examines the oral cavity of the Patient for sores and the cheeks and neck for any lumps.
  2.  Endoscopy: Fhis-scopes & flexible and thin tube-like instrument that is attached with a small camera and light at the end. It is inserted through the nose to examine the head and the neck of the patient. It is also used to examine the back of the mouth and throat. 
  3. Biopsy: Small tissues from the sores are collected and are examined for malignancy.
  4. Barium swallow study: A series of x-rays are taken after making the patient swallow liquid barium.
  5. CT and MRI: These tests help in learning the extent of the spread of the tumor outside the oral cavity, 

Pre-Surgery Preparation

Commando surgery is a major surgical procedure and involves stringent pre-operative preparations. It is important not to eat or drink anything a night before the surgery. Tracheostomy is performed to maintain enough breathing after the surgery. Feeding tubes are inserted through the nose to maintain enough nutrition in the postoperative period.

Post-Surgery Recovery

After surgery, the patient is shifted to the intensive care unit for a day or two and then moved to their recovery bed. During the ICU stay, the surgeon and the anesthetist will keep a close eye on the progress of the patient. The patient is given enough painkillers to help them bear with the pain. An IV line in the arm helps with enough hydration. The patient will be connected with a breathing tube in the neck. After the surgery, there can be changes in how one chews and swallow. There can be changes in the way one breathes and talks, and there can be a significant change in one's appearance as well. 

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