Chapter 89 - Part E: Successful Resection, Failed Patient: The Jaw Surgery Trap

In this BoardsCast episode, we conclude Tobias Chapter 89 - Mandibulectomy and Maxillectomy with a hard surgical truth:
 a perfectly executed jaw resection can still leave you with a failing patient.

In jaw oncology, the resection is only half the operation. The other half is biomechanics, alignment, occlusion, airway, soft-tissue tension, salivary contamination, nerve disruption, and postoperative function. When those pieces don’t align, a “successful” surgery quickly becomes a clinical failure.

This episode exposes the hidden traps behind mandibular and maxillary resections and explains why function—not margins—is the true determinant of success.

You’ll learn:

• Why biomechanical destabilization is the #1 cause of postoperative failure
• How loss of occlusion leads to drift, malalignment, and feeding dysfunction
• Why maxilla and mandible fail in completely different ways
• How tension, saliva, and muscle imbalance sabotage reconstruction
• Board-relevant patterns of lingual nerve injury, mandibular drift, palatal defects & oronasal communication
• Why reconstruction sometimes increases failure risk instead of preventing it
• Practical strategies to keep your resection from becoming a disaster

This episode teaches you how to prevent the functional failures that occur after the margins are clean.

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Listen On:
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Chapters

• 0:00 Introduction: The "Clean Margin" Tragedy
• 1:00 Defining the Trap: When the Specimen is Better than the Patient
• 2:30 The Mechanics of Survival: Prioritizing Lapping and Swallowing
• 4:15 The Cat vs. Dog Reality: Adaptation and Inappetence Rates
• 6:50 Mandibular Drift: Managing the mechanical shift of the remaining jaw
• 9:44 The "Couch Test": Quality of Life as the Ultimate Metric
• 12:15 Owner Communication: Preparing for the "Messy" Recovery
• 14:30 The Ethical Edge: Knowing when to stop the resection
• 15:45 Final Thought: Success is a Functioning Patient