This article is our translation of a news story from Singapore newspaper The Straits Times which was first published on 29 October 2010 for the information of our Indonesian patients and colleagues.
Disabled and sick patient after surgery in Jakarta to remove tumor.
When Mr. Rudolf Santoso had his lower jaw removed due to a tumor, he did not expect to suffer prolonged pain after the operation.
The 52-year-old Indonesian man underwent surgery in Jakarta to remove a 7.5cm tumor on his lower jaw and had 70 percent of his lower jaw replaced with a titanium plate.
However, this led to repeated infections for more than five months and he eventually sought treatment in Singapore.
Here, in a rare example of specialists from both the dental and medical fields working together, a team of four doctors not only got the operation right, but also managed to complete it in record time.
The team consists of Professor Ansgar Cheng (maxillofacial prosthodontist); Dr. Andrew Loy (consultant ear, nose, throat, and head and neck surgery); Dr Erik Ang (consultant plastic surgeon); and Dr Ho Kok Sen (oral and maxillofacial surgeon).
All four are specialist doctors who practice at Mount Elizabeth Medical Centre.
Prof. Cheng was the first to meet Mr. Santoso, the supervisor of an industrial area. He assembled a team of specialists and coordinated a treatment plan for Mr. Santoso.
“When doctors start treatment on a patient, they try to have a good idea of the functional outcome. But Mr. Santoso’s doctor abroad started the treatment process without knowing the end point,” said Prof. Cheng, who also treats dental patients.
The Indonesian man has a rare condition known as ameloblastoma, a slow-growing tumor in the jaw caused by cells that are supposed to develop into tooth enamel. While the tumor is not life-threatening, doctors in Jakarta have recommended removing it because it will continue to grow if not treated early.
After removing 70 percent of his lower jaw, a titanium plate was inserted. This left Mr Santoso with a prolonged infection and two gaping holes – one visible from the mouth and the other from the neck.
“There was pus coming out of the wound on my neck, and a bandage had to be placed there permanently.”
“I also had to take frequent leave to have the infection cleaned by the doctor. The pain was unbearable,” said the patient who lost more than 20kg during that period.
The infection also affects the quality of life dramatically.
He couldn’t eat or speak properly and he felt ugly: The absence of a lower jaw made the father of two grown children look like he was 70 years old.
Feeling hopeless and desperate, he began seeking opinions from other doctors in Indonesia.
On the advice of a friend, he emailed the Specialist Dental Group , where Dr. Ho and Prof. Cheng worked, to ask for help.
The team in Singapore planned a treatment that involved surgery to remove a bone that was not needed for walking from his left leg, and implant it in his mouth.
After the bone graft in the mouth healed, three months later, Dr Ho took over to place the dental implant.
A procedure like this, which normally takes a year to complete, was completed in just over three months.
“The first operation took place in June this year, and the implant was placed in September.”
He is now able to speak and eat properly, even though all of his teeth underneath are implants.
Mr Santoso, who has a 48-year-old wife, also looks 95 percent his former self, although doctors do not know his real face.
He said, “My self-confidence has really been affected after the treatment in Jakarta. Now not only can I return to my normal activities, but I also feel more handsome.”
