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Jim Kelly's doctor explains jaw reconstruction procedure

Hall of Fame quarterback Jim Kelly is scheduled to undergo surgery Wednesday morning at Mount Sinai Hospital in New York following a recurrence of oral cancer.

Kelly announced in early March that he had squamous cell carcinoma in the upper right jaw, a similar form of the disease that was surgically removed from his upper left jaw at ECMC in 2015.

The recurrence was detected when he had a biopsy in advance of a planned procedure to have his upper left jaw – part of which was removed, along with a portion of his palate – reconstructed to help relieve severe pain he has felt for three years. The plan then shifted to have it removed and reconstruction done on both sides.

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Kelly said he sought to have the reconstruction because he no longer could continue dealing with pain for which medication was no longer providing sufficient relief. He also no longer wanted to have the prosthesis he has had filling the gap left by the previous surgery.

Dr. Mark Urken, an otolaryngologist and head and neck surgeon at Mount Sinai, will handle the operation.

"The extent of what we were originally planning to do is not significantly different now," Dr. Urken told The News by phone from New York. "At this point, there's a slightly different focus with ensuring that all of this cancer that's present, which is not a large amount of disease, based on exam and based on the imaging studies that have done very recently. The expectation is that that won't change the operation significantly. I feel very confident that we're going to be able to get not only around this tumor very readily but also get Jim back on track here with, hopefully, a better quality of life moving forward."

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Dr. Urken said the surgery, similar to the 2015 procedure, would involve the removal of part of Kelly's upper jaw and a segment of his palate. Using a technique called microvascular reconstruction, Dr. Urken said he would take a portion of the fibula from one of Kelly's legs – along with attached soft tissue and blood vessels – and insert it in his upper jaw.

"We contour that bone so that it functions as a new jaw for him and to then restore the circulation to that bone so that it can heal and survive in this new environment the way we want it to in order to create a new jaw," the doctor said.

Dr. Urken said that the leg from which part of Kelly's fibula is removed would function normally. The fibula is chosen because it is a non-weight-bearing bone.

"We don't interrupt the knee or the ankle joint where the fibula is part of that structure," the doctor said. "We take that central portion of it in order to redesign it and, essentially, repurpose it into functioning as a new jaw for him. But it will not affect Jim's gait or his ability to go back to playing sports, cycling, doing just about anything you want to do."

First, though, there is recovery. Kelly is expected to be attached to a feeding tube and trach tube for two weeks after the surgery.

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