North Texas Dentistry Volume 8 Issue 1 NTD 2018 ISSUE 1 DE | Page 8

Photo courtesy of Dr . David Kang
Dr . Kang is the only OMFS in North Texas performing trans-oral robotic surgery procedures .
remove loose teeth , which can give the cancer an opportunity to invade into the bone through the extraction socket , and spread through the marrow space . In this case , a tumor that could have been treated with a marginal mandibulectomy can quickly progress to require the removal of the entire segment of the jaw .” If the cancer spreads and a radical dissection is required , muscles , nerves , and vasculature may be removed , significantly impacting the functional and aesthetic outcome .
Prior to surgery , for mandibular or maxillary cancers , Dr . Kang often uses virtual planning tools in a GoToMeeting ™ session to plan out surgical treatment . This enables Dr . Kang to virtually excise the tumor , reconstruct the defect using a fibula free flap , prepare a custom titanium implant , and then print surgical guides to use in the OR . The virtual surgery saves time and improves accuracy and detail , resulting in an optimally functional and aesthetically superior outcome .
In the hands of a skilled , experienced surgeon , oral cancer surgery optimizes the chances of long-term survival while preserving function and aesthetics . Because Dr . Kang is specially trained in surgery of the oral cavity , he can make smaller incisions to access the lesion transorally . He ensures removal of the entire cancerous lesion with the help of a pathologist who prepares and analyzes frozen sections in the operating room to verify that all malignant tissue is removed . He often helps to orient the specimen for the pathologist using illustrations and photos so there is no confusion . For certain tumors , if adequate tissue is removed , adjuvant therapies such as chemotherapy or radiation to help decrease the risk of cancer recurrence may not be required .
In the past , a plastic surgeon would typically perform reconstruction following oral cancer surgery , with a focus on closure of the defect in order to proceed with adjuvant treatment . By contrast , Dr . Kang , as an oral and maxillofacial surgeon , is specifically trained to understand and reconstruct the oral cavity with a focus on both functional and aesthetic outcomes . “ Often , I tell patients that no matter what we do , we will never be able to reconstruct them to the exact way they were prior to their cancer diagnosis , however , it is my goal to get them to as close as possible to the way they were before . It ’ s clearly beneficial to the patient to restore functional outcome as well as achieve the desired aesthetic outcome . When a patient ’ s tongue functions normally and they regain the ability to eat and speak like they did before surgery , smile naturally , have natural looking facial contours , and be set up to receive dental implants , we achieve a better quality of life .”
Because Dr . Kang uses bone from the fibula to reconstruct the jaw , the new bone is slightly different than normal mandibular or maxillary bone . If the referring doctor feels comfortable with this difference , Dr . Kang can return the patient to the referring doctor ready to receive dental implants . Alternatively , Dr . Kang can place the implants in the operating room , sometimes on the same day of surgery .
Dr . Kang ’ s special expertise is an invaluable resource for North Texas dentists and their patients . In addition to his rare expertise , he is known for his warmly personal , patient-oriented approach . He takes as much time as necessary to get to know each patient , answer their questions , and earn their trust . Although the diagnosis of cancer is almost always accompanied by fear and uncertainty , his compassionate approach before surgery and his commitment to follow-up care puts them at ease . Dr . Kang notes , “ The experience of oral cancer is a lifechanging event . I am deeply honored to have patients place their care in my hands .”
According to the Oral Cancer Foundation , any sore , discoloration , induration , prominent tissue , irritation , hoarseness , which does not resolve within two weeks on its own , with or without treatment , should be considered suspect and worthy of further examination or referral .
Head and Neck Surgery of North Texas PLLC is located at 1411 North Beckley Avenue , Pavilion III , Ste . 152 , Dallas , TX 75203 . For more information , call ( 469 ) 713-2038 or visit drdavidkang . com .
1
“ Oral Cancer Facts .” The Oral Cancer Foundation , oralcancerfoundation . org / facts /.
2
“ Surgeons of Oral Cancer and Leaders of a Young Specialty : The Role of 3 Oral and Maxillofacial Surgeons ” Eric J . Dierks , MD , DMD * American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 60:86-92 , 2002 .
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