This case involves a 66-year-old woman with a history of multiple surgeries for oral cancer over 5 years and 15 treatments of radiation therapy. She was diagnosed with squamous cell carcinoma of the tongue and floor of the mouth. She was given a bone graft from the anterolateral thigh flap which eventually failed. Following the graft failure, the patient developed an oral infection and sought a second opinion and followed up with a different ENT specialist. The subsequent ENT specialist opinion was that the bone graft never should have been done because it put the patient at a significant risk of failure and that it gave her no alternative or recourse for subsequent action. An expert in oral and maxillofacial surgery was sought to opine on the standard of care.
Question(s) For Expert Witness
1. How often do you see patients with squamous cell carcinoma of the tongue?
2. Given the patient's complicated past medical history, was a bone graft at a higher risk of failure?
3. What are the options for reconstruction in a patient like this one?
Expert Witness Response E-008352
As the director of predoctoral oral and maxillofacial surgery program at my institution, I see patients with squamous cell carcinoma of the tongue at least 2 to 3 times monthly, often more. Radiation, in particular, makes reconstruction more difficult. Other options for reconstruction depend on more case particulars, but in general, they include autogenous cortico-cancellous bone graft or vascularized bone graft.
About the author
Wendy Ketner, M.D.
Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.
Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.
Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.
