Dr. David Kang
Dr. David Kang, assistant professor in oral
and maxillofacial surgery, has joined Texas
A&M University Baylor College of
Dentistry as its first head and neck oncologic and microvascular reconstructive surgeon. The description is complex, but the
meaning isn’t lost on patients with oral
cancer facing the reality of surgery.
This dual-trained dentist and physician
spent an additional year after his oral surgery residency to complete a fellowship in
head and neck oncologic surgery at the
University of Michigan. He has returned to
Dallas with the in-depth training he needs
to not only remove cancerous head and
neck tumors but also reconstruct the entire
surgical area — providing a critical step in
a patient’s return to normalcy following a
life-altering diagnosis and treatment.
Kang anticipates coordinating a multidisciplinary approach to caring for cancer
patients with the various medical oncology
specialists involved in their treatment.
“Our patients are frequently presented to
the Head and Neck Tumor Board, which
meets at the Baylor Charles A. Sammons
Cancer Center the second and fourth
Tuesday of the month,” Kang said. “At this
meeting we discuss treatment options
including surgery, radiation therapy and
chemotherapy.”
Kang expects most of his referrals to come
from oral and maxillofacial surgeons and
dentists in North Texas, he says. When
referral to a surgeon specializing in head
and neck oncologic surgery is indicated,
A New Era in
Treating Head
and Neck Cancer
by Jennifer E. Fuentes
several different avenues are available
including oral and maxillofacial surgeons,
otolaryngologists and general surgeons.
Many of the patients Kang treats are dealing with the reality of radiation — a treatment that, while often effective at
combating cancer, is notorious for wreaking havoc on the environment in the
mouth. He takes special steps to ensure
that the patient’s reconstruction holds up
to the radiation that may occur postsurgery.
“In the past, there was significant morbidity and decreased quality of life associated
with oncologic resections resulting in loss
of facial aesthetics, speech and ability to
eat, sometimes leading to a hermetic
lifestyle,” Kang said. “With the advancement of microvascular reconstructive surgery, we can now take composite free tissue
— skin, fascia, muscle, nerve, bone — to
reconstruct any maxillofacial defect
regardless of size and return form and
function to the patient.
“Free tissue transfer — or free flap — has
become the gold standard in reconstruction of the difficult three-dimensional
aspect of the oral cavity.”
This procedure also provides immediate
blood flow to the tissues and rapid healing
of the surgical site, which allows the initiation of radiation therapy within four to six
weeks.
Although reconstruction is always an
option, Kang said it may not be the best
choice for the patient because reconstruc-
tion with free tissue transfer requires
longer operating room time, a longer hospitalization and frequently a tracheostomy.
He said the need for free tissue transfer is
weighed against the patient’s medical status and their physiological age rather than
chronological age.
“We will often opt for placement of an
obturator, which is very similar to a denture and closes off the defect as well as
restores facial contour,” Kang said.
“Sometimes, reconstruction with free tissue transfer requires multiple surgeries
and revisions, and the results may not look
as good as a prosthetic, such as with a total
rhinectomy. In that case our department’s
Center for Maxillofacial Prosthodontics
has anaplastologist Suzi Verma, who can
create beautiful reconstructions for our
patients including noses, ears, eyes and
portions of the face.”
For patient referrals, contact the
Department of Oral & Maxillofacial
Surgery at (214) 828-8403.
Founded in 1905, Texas A&M University Baylor
College of Dentistry in Dallas is a college of the
Texas A&M Health Science Center. TAMBCD is a
nationally recognized center for oral health sciences
education, research, specialized patient care and
continuing dental education.
Jennifer Eure Fuentes is a communications specialist at Texas A&M Health Science Center Baylor
College of Dentistry. A 2006 graduate of Texas
Christian University, she has worked in the communications and editorial field for five years.
www.northtexasdentistry.com
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