82yo male for mandibular reconstruction

Background

• Parotid tumour with mandibular involvement → radiotherapy and subsequent trismus
• Previous AFOI for resection, but unsuccessful surgery
• Asbestosis with pleural plaques
• T2DM

Issues

• Osteonecrosis of mandible → seen by ENT outpatient clinic → nil acute intervention required
• Poor spirometry, but inadequate study due to being unable to fit mouth of spirometer mouth-piece. Reassuringly, able to ride bike 8-10km/d.

Discussion

• Reassuring functional capacity despite poor spirometry
• Has not been on any agents associated with osteonecrosis of jaw (denosumab)
• Reassuring the patient had successful AFOI in past. Previously good experience

Plan

• No acute changes or interventions required