Oral & Maxillofacial Surgery

Oral-Maxillofacial Surgery Services

• Anesthesia Services

  All of our faculty and staff are trained in administration of anesthesia. Due to this extensive amount training and experience, we are fully capable in providing you with the most comfortable and pleasant anesthetic experience at our offices located at Galveston and League city.

  Watch the videos here at the MyOSM.org website and see how we can provide you with the best experience at our clinics.

• Dental Implants

  Dental implants are the long-term solution for your missing teeth. If properly cared for, dental implants can last a lifetime. The implants are made of titanium and usually take several months to fuse with your jaw bone, in the process known as Osseointegration. Our experts here at UTMB are trained in management of the most complex cases and they are here to help you to get your teeth back.

  Learn more about Dental Implants here at the MyOSM.org website.

• Extractions and Other Oral Surgeries

  There are many oral surgical procedures that we are capable of performing here at UTMB. Most of these procedures can be done in the clinic setting using the safest and most comfortable anesthetic techniques appropriate for your surgery.

  Learn more about Extractions and Other Oral Surgeries here at the MyOSM.org website.

• Facial Trauma and Soft Tissues Trauma

  Oral and Maxillofacial Surgeons (OMSs) are experts in treating and repairing facial injury and trauma, including fractures of the upper and lower jaws and the orbits surrounding the eyes, and facial lacerations. Their knowledge of how jaws come together (dental occlusion) is critical when repairing complex facial fractures. Many of the techniques that are standard in today's hospital emergency rooms were developed by OMSs in combat hospitals during World War II, Korea, Vietnam and today's international conflicts.

  Trauma care is provided through UTMB Health Level 1 Trauma Center at Galveston.

  

• Head and Neck Infection

  Infections within the head and neck, including your jaw bones (mandible and maxilla), may occur as a result of dental infection, exposure to radiation for treatment of a head and neck cancer (osteoradionecrosis-ORN) or as a result of exposure to a bisphosphonate medication (MRONJ). The treatment may range from medical therapy (Antibiotic), simple incision and drainage, and possibly to advanced surgical techniques with immediate jaw reconstruction using microvascular free tissue.

  The UTMB faculty are experts in the management of these conditions. We work closely with the infectious disease team at UTMB Health to provide you with the best care tailored to your condition.

• Nerve Repair and Reconstruction

  The division of Oral and Maxillofacial Surgery at UTMB utilized the latest cutting-edge technologies and advancement in the field of nerve repair and reconstruction. We are able to alleviate pain and restore function that has been lost due to nerve damage and disease.

  Dr. Marwan is a fellowship-trained expert specialize in both, nerve surgery following traumatic injury and microsurgical techniques. These techniques treat the nerves, which are the most vital and delicate structures that carry messages from the brain to the rest of the body.

• Obstructive Sleep Apnea Surgery (OSA)

  Obstructive sleep apnea is a serious and even life-threatening condition. The risks of undiagnosed OSA include heart attack, stroke, irregular heartbeat, high blood pressure, heart disease and decreased libido. In addition, OSA causes daytime drowsiness that can result in accidents, lost productivity and relationship problems. 

  The National Sleep Foundation estimates that 18 million adults have obstructive sleep apnea and it is likely that OSA also affects 2% to 3% of children. Yet, people who have OSA may not be aware they have a problem. If someone close to you has spoken of your loud snoring and has noticed that you often wake up abruptly, gasping for air, you should consult us at UTMB Oral and Maxillofacial Surgery. Our Surgeons are the experts in diagnosis and surgical management of obstructive sleep apnea.

  Learn more about Obstructive Sleep Apnea Surgery (OSA) here at the MyOSM.org website and at SleepApnea.org

• Oral and Maxillofacial Pathology

  The oral cavity has multiple structures that can be affected by various disease processes. Any alteration in this appearance could be a warning sign for a pathological process with the most serious is oral cancer. Generally speaking, biopsy is considered the gold standard to establish a diagnosis, often able to be performed in the outpatient clinic under local or IV sedation.

  Dr. Marwan is an expert in the management of oral/head and neck cancer and benign conditions of the jaws. Also, he provides a compassionate and comprehensive care for all of his patients from diagnosis until treatment and follow up.

• Oral/Head and Neck Oncology

  Your oral and maxillofacial surgeon (OMS) is the expert for diagnosing and surgically treating cancer of the head, neck and mouth.

  The Oral Cancer Foundation estimates that close to 42,000 Americans will be diagnosed with oral or pharyngeal cancer this year. Oral cancer’s mortality is particularly high, not because it is hard to detect or diagnose, but because the cancer is often discovered late in its development.

  Don't ignore any suspicious lumps or sores. Should you discover something, make an appointment for a prompt examination. Early treatment may well be the key to complete recovery.

  Oral/Head and Neck cancer treatment requires a multidisciplinary approach to care involving surgeons, radiation oncologists, medical oncologists, speech/language pathologists, maxillofacial prosthodontists, nutritionists and rehabilitation therapists.

  The Oncology team at UTMB are an experienced team of surgeons with a focus on the surgical management (ablation and reconstruction) of cancers of the head and neck.

  Dr. Marwan is trained in all aspects of the surgical management (Ablation and Reconstruction) of Oral/Head & Neck cancer. Also, he is an active member in the Head and Neck Multidisciplinary Tumor Board at UTMB.

  To learn more about Oral/Head & Neck Cancer visit the following links:

  • https://myoms.org/procedures/oral-head-and-neck-pathology
  • https://oralcancerfoundation.org/
  • https://www.headandneck.org/
• Orthognathic (Jaw) Surgery

  Orthognathic surgery, also called corrective jaw surgery, is performed by an oral and maxillofacial surgeon (OMS) to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth.

  Surgery can improve chewing, speaking and breathing. While the patient's appearance may be dramatically enhanced as a result of the surgery, orthognathic surgery is performed to correct functional problems.

  We work very closely with the orthodontist and your general dentist to plan and decide the best surgical procedure to correct your jaw deformity. During your visit, we will show you how your bite will be improved and how you will look after the surgery.

  Also, we pride ourselves by using the cutting-edge computer technologies and virtual surgical planning to perform your case with extreme accuracy.

  Learn more about Orthognathic (Jaw) Surgery here at the MyOSM.org website.

  
  

• Reconstructive Surgery of the Head and Neck

  The division of Oral and Maxillofacial Surgery at UTMB offers a comprehensive reconstruction for all cancer related and post traumatic defects for both children and adults.

  We proud ourselves by implementing cutting edge and state of art technologies in planning your reconstruction. This will provide you with the most precise reconstruction of the defect.

  Microvascular reconstruction is one of the most advanced options in restoring facial form and function following the removal of facial and oral tumors. These techniques are also used to repair defects caused from traumatic injuries. Tissue from the patient’s own body are transplanted into the facial defects to restore function and appearance. These transplants (known as “flaps”) can be in the form of skin, muscle, bone, or any combination. The flap is removed from the body along with blood vessels that supply nourishment to the flap. The blood vessels are reconnected to vessels around the facial defect under a microscope using sutures smaller than a human hair. Once blood flow is re-established, the transplanted tissue remains alive just as it did in its original location. Because the flap is completely freed from another part of the body, this technique is often referred to as “free flap surgery” or “free tissue transfer.” This technique has a 95 percent success rate, which is very favorable compared to other techniques. Please keep in mind that many cases are more appropriately reconstructed with alternative techniques.

  While not all patients are candidates to undergo this form of reconstruction, our surgeons also perform many other forms of facial reconstructive surgery. The optimal reconstructive technique is tailored to each patient and chosen based on the patient’s wishes, goals, and available options.

  Dr. Marwan is fully trained Oral/Head and Neck microvascular Surgeon and he utilizes the Microvascular surgical techniques to immediately reconstruct the cancer related defects. In addition, He is trained to perform jaw reconstruction using the stem cells and the tissue engineering techniques, without the use of bone graft from other region of the body, if indicated.

  

• Salivary Gland Disorders

  The salivary glands produce saliva. Saliva plays an important role in supporting your oral and overall health.

  The three major salivary glands are parotid gland, submandibular gland, and sublingual gland, with one on each side of the neck. In addition to major salivary glands, there are hundreds of small minor salivary glands which are embedded within the lining of the head and neck.  

  The conditions that can affect salivary glands are:

  • Viral or bacterial infections
  • Chronic inflammation (sialadenitis)
  • Formation of salivary stones (sialolith)
  • Benign tumors or cysts
  • Salivary cancers

  Every salivary disorder is unique in its symptoms. Generally, there will be swelling either along the cheeks or under the jaw and at times, pain if the salivary disorder is due to an infectious or inflammatory process. Patients who develop a salivary gland tumor, usually notice a mass that slowly grows over time. 

  At UTMB, we have the specialized skills to treat the full breadth of salivary disorders, both benign and malignant. Our services range from the diagnosis of inflammatory conditions to complex surgical removal of salivary gland cancers. We also have cutting-edge technologies such as salivary gland endoscopy. 

  Salivary diagnostics:

  • Fine needle aspiration of salivary masses
  • Biopsy of mouth and palatal tumors
  • Minor salivary gland biopsy for inflammatory (e.g. Sjogren’s syndrome/disorders)

  Minimally invasive salivary therapy:

  • Diagnostic salivary endoscopy
  • Symptomatic management of inflammatory disorders
  • Treatment of salivary infections
  • Botulinum toxin injection

  Salivary stone removal:

  • Endoscopic salivary stone removal
  • Transoral removal of salivary stones
  • Parotid gland sparing endoscopic assisted stone removal

  Parotid and submandibular tumors:

  • Submandibular gland resection
  • Parotidectomy
  • Treatment of recurrent salivary tumors
• Temporomandibular Joint (TMJ)

  Are you suffering from TMJ disorder?

  The temporomandibular joint (TMJ) is the joint that connects your jaw to your skull. The temporomandibular joint disorder is a group of conditions that affect the temporomandibular joint. TMJ disorders can cause various symptoms, including pain, clicking or popping in the jaw, difficulty opening or closing the jaw, ear pain, and headaches. When symptoms of TMJ trouble appear, consult an oral and maxillofacial surgeon (OMS). A specialist in the areas of the mouth, teeth, and jaws, your OMS has the expertise to diagnose the problem correctly. TMJ disorders can be complex and may require different diagnostic procedures. Special imaging studies of the joints may be ordered, and appropriate referral to other dental or medical specialists or a physical therapist may be made.  If you are suffering from TMJ disorder, several treatments can be provided by Oral and Maxillofacial surgeons here at UTMB. In some cases, surgery may be necessary.

  What is TMJ surgery?

  TMJ surgery is a procedure that is used to repair or replace the temporomandibular joint. There are various types of TMJ surgery, and the type of surgery that is right for you will depend on the severity of your condition. What are the benefits of TMJ surgery? If you are suffering from severe TMJ disorder, TMJ surgery can provide several benefits, including:

  • Pain relief
  • Improved jaw function
  • Reduced headaches
  • Improved quality of life

  If you are considering TMJ surgery, it is essential to talk to your doctor about the risks and benefits of the procedure. Your doctor can help you decide if TMJ surgery is right for you. Here are some of the most common types of TMJ surgery:

  • Arthroscopy: is a minimally invasive procedure that uses a small camera and surgical instruments to view and repair the TMJ.
  • Arthrocentesis: is a minimally invasive procedure that uses a small needle to flush the joints. This helps to reduce inflammation and pain. In some cases, a corticosteroid medication may also be injected into the joint. 
  • Open-joint surgery: Open-joint surgery is a more invasive procedure that involves making a larger incision in the jaw to access the TMJ.
  • Discectomy: A discectomy is a procedure that removes the disc in the TMJ.
  • Disc replacement: A disc replacement is a procedure that replaces the disc in the TMJ with an artificial disc.
  • Total or Partial Joint Replacement: In the most severe cases, patients may benefit from a total joint replacement.

  The recovery time for TMJ surgery varies depending on the type of surgery that is performed. You can generally expect to be hospitalized one to two days after surgery. You will also need to take time off from work and other activities. If you are considering TMJ surgery, finding a qualified surgeon with experience performing these procedures is crucial. Dr. Hisham Marwan and Dr. Camilo Mosquera are fully trained in both non-surgical and surgical management of TMJ disorder and provide the best care to the patients at UTMB. 

• Vascular Tumors and Malformation in the Head and Neck

  The Hemangiomas in children and vascular malformation in adults are relatively common in the head and neck region. They often occur within the tongue causing symptoms of speech impairment, swelling and swallowing dysfunction. Treatment includes both non-surgical (sclerotherapy) and surgical removal with reconstruction.

  
  

• Wisdom Teeth

  Wisdom teeth, or third molars, are the last teeth to appear in your mouth. They usually come in between the ages of 17-25. Wisdom teeth are called impacted when they don’t fully grow, and this happen when there is not enough room in the mouth. Impacted wisdom teeth can damage adjacent teeth and get infected. Also, in some cases tumor or cyst might develop from these teeth, which leads to multiple serious problems. We encourage all of our patients to have their third molars checked by Oral and Maxillofacial Surgeon. The worst thing that you can do is to ignore your wisdom teeth.

  Learn more about Wisdom Teeth here at the MyOSM.org website.