In a very unique medical case and a first in the medical history of Western Odisha, a person whose tongue was diagnosed with cancer got replaced by his forearm tissues, at JP Hospital, Rourkela. This was made successful by a team of JP Doctors comprising Dr.Ghanashyam Mandal Senior Consultant ENT and Head & Neck Cancer Surgeon; Dr. Ankita Joshi Senior Consultant ENT; Dr. Kuldeep Sharma Senior Consultant Plastic Surgeon and; Dr.Subhasish Panigrahi Consultant Dental Surgeon.
Manohar Bagh a 21 years old male from Sambalpur came to JP Hospital with a large non-healing ulcer on his tongue, which was troubling him for more than two months. The patient had a history of impulsive tobacco chewing habits. The initial consultancy was done by Dr.Ghanashyam & Dr. Ankita and the patient was advised to go for a biopsy test, which revealed squamous cell carcinoma. The patient was further evaluated to know the extent of the spread of the disease. Finally, as per the histopathology report, the JP Doctors’ team planned to go for tongue removal, neck dissection and reconstruction of tongue surgery and adjuvant treatment, as per the final histopathology report. Now removal of tongue cancer implied impairment of speech & swallowing function for the patient. To avoid this it was decided to go for the microvascular reconstruction of the tongue, using tissues from the patient’s forearm. This procedure which is called Free Flap reconstruction involves moving healthy, live tissue from one location of your body to another was done. This involved using a portion of the patient’s forearm tissues to create a flap based on the shape and size of the piece of the tongue being removed.
The patient was operated on by a team of Dr.Ghanashyam, Dr.Ankita, and Dr.Subhasish and microvascular reconstruction was done by Dr.Kuldeep.During surgery, Frozen Section Technology (available at only a few premier hospitals) was used to ensure that tongue cancer was completely removed. Dr.Suchitra Sahoo HOD JP Path Lab confirmed the complete removal of tongue cancer within 20 minutes of surgery using this technique.
To enable the patient to breathe, a tracheostomy was done. The patient responded well to the treatment and started walking on the second day. The liquid diet was started on the sixth day. The tracheostomy tube was removed on the seventh day. A feeding tube was removed on the tenth day and, the patient was ready for discharge. Now the patient can speak & eat well through the mouth. For 1st time in Western Odisha, this Free Flap Reconstruction Surgery for the tongue was performed, adding another milestone for JP Hospital.
