North Texas Dentistry Magazine, Volume 3 Issue 7 | Page 5

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 | NORTH TEXAS DENTISTRY 5