For 23 years, Ms Thu Thuy (46 years old, residing in Ho Chi Minh City) was unable to open her mouth to speak and eat normally after her jaw became fused after enduring severe burns from a charcoal oven.
Ms Thuy had to push tiny pieces of food through a gap in her jaw to survive. Now, she has a new lease of life after her jaw was separated during a successful joint spacing surgery at FV Hospital.
Pain piled upon pain
Ms Thuy still remembers the fateful day of March 8, 2000. After experiencing a devastating miscarriage, she warmed herself by sitting close to a charcoal stove in a bathroom. Unfortunately, the bathroom was small and poorly ventilated and Ms Thuy inhaled toxic fumes which caused her to lose consciousness and slump forward, her face pressing against the hot stove. When her family found her and rushed her to the hospital, Thuy had suffered severe burns to the left side of her face and neck.
On top of the mental anguish from losing her baby, Ms Thuy had to endure more physical and psychological pain as she received more than 20 major and minor surgeries to treat her burns. Her left hand had to be amputated. She had multiple surgeries to treat or cut away inflamed or necrotic tissue, and her left eye and lower left jawbone were removed. Ms Thuy lost almost all of the bones on the left side of her face. Over time, the muscles on her face contracted, making it impossible for her to open her mouth.
After the accident, Ms Thuy had to undergo more than 20 surgeries for the treatment and reconstruction of her face and neck. Here, the left side of her face is contracted and her temporomandibular joints are adhered, making it impossible for her to open her mouth.
From a happy woman in her twenties, Ms Thuy became extremely self-conscious about her appearance and condition. She secquestered herself indoors for five years because whenever children saw her outside, they would cry, and adults would whisper and gossip about her.
Mr Minh was deeply moved as he spoke about his wife’s situation.
Looking back on those days, Mr Minh, Ms Thuy’s husband, still feels deeply saddened. “For meals, I had to use a small spoon to feed her rice and push meat into her mouth with my hand through the gap in her broken jaw. She couldn’t chew, only swallow. Whenever she wanted to say something, she had to force herself to speak. It was heartbreaking,” he shared.
Seeking every possible way to treat excruciating pain
With their savings and assistance from siblings, Ms Thuy and her husband visited numerous hospitals across the country hoping to find a definitive treatment for her severe jaw stiffness. However, doctors were unable to provide a specific treatment plan.
Due to her inability to maintain proper oral hygiene, Ms Thuy often suffered from toothaches and dental infections. Unable to bear the pain, in December 2023, she sought treatment at another hospital. While surgery was scheduled, it was cancelled at the last minute because she couldn’t undergo anaesthesia via endotracheal intubation. The excruciating pain tormented her, prompting the couple to continue seeking treatment elsewhere.
Upon the recommendation of relatives, Mr Minh brought his wife to FV Hospital for a consultation. After being examined by Dr Tung and consulting with other specialists, the family was overjoyed to learn that the doctors had agreed on a surgical plan for Thuy. “As long as the doctors agree to treat her, we have hope,” Mr Minh expressed.
Nguyen Thanh Tung, MD, PhD, oversaw Ms Thuy’s treatment team.
Nguyen Thanh Tung, MD, PhD, Head of the Oral & Maxillofacial Surgery – Dental Surgery Department at FV Hospital, stated that Ms Thuy’s case was challenging and required the collaboration of multiple specialists, including anaesthesiologists, endoscopists, and nutritionists.
“To extract deeply embedded teeth, we must find a way to open the patient’s mouth. When a patient has not been able to open their mouth for over 20 years, the temporomandibular joints do not function normally and gradually degenerate and adhere. In this particular case, the patient had numerous surgeries to remove necrotic bone tissue, excise inflamed tissue in the left jaw area, and experienced prolonged jaw stiffness, leading to the formation of bone bridges between the upper and lower jaw on the left side, worsening her jaw stiffness,” Dr Tung explained.
The surgery required four steps: First, creating a gap between the temporomandibular joints to release the adhered joints, followed by inserting a muscle flap to prevent the lower jaw from retracting after the joint separation and limiting joint re-adhesion. Second, excavating and releasing the bone bridges between the upper and lower jaws on the left side. Then she required scar revision to release the contracted scars in her left cheek and left side of her face and neck. The final step involved dental treatment, including extracting painful teeth.
Ms Thuy’s case presented a significant challenge in anaesthesia. Since she couldn’t open her mouth, it posed difficulties for administering anaesthesia (as the endotracheal tube couldn’t be inserted orally). During the interdisciplinary consultation, anaesthesia specialists proposed administering anaesthesia via the lower nasal route with flexible endoscopy support. If this method failed, then opening the airway in the neck would be necessary for anaesthesia, although this is an invasive approach.
“We considered using endoscopy-assisted nasal anaesthesia, and if that failed, we would resort to opening the airway. As FV Hospital is a multi-specialty hospital, it was easy to collaborate with other experienced specialties such as Otorhinolaryngology and Gastroenterology & Hepatology to assist with endoscopy. In this case, we invited Dr Ngo Van Huy, an expert in endoscopy from the Gastroenterology & Hepatology Department, to assist with the endoscopic guidance for nasal anaesthaesia,” Dr Ly Quoc Thinh, Head of the Anaesthesiology & ICU Department, explained.
The nasal anaesthesia procedure went smoothly due to the collaboration of two specialists, facilitating the subsequent surgery performed by Dr Nguyen Thanh Tung’s team as planned. After over six hours of surgery, Ms Thuy’s jaw joint separation surgery was successful, bringing joy to the entire team, her family, and Ms Thuy.
After 20 years of being unable to open her mouth, a young woman gets to live a new life.
When her bandage was removed after the surgery, Ms Thuy was moved to tears when she could open her mouth for the first time in over 20 years. Her jaw muscles no longer caused her excruciating pain when she opened her mouth, and she could pronounce words clearly without hesitation. Even better: Ms Thuy could eat easily.
When asked what she wanted to do when she returned home, Ms Thuy smiled and said, “I want to eat something really delicious!” Then, she enthusiastically talked about the happiness of being able to chew and swallow normally in recent days, experiencing the simple joy of savouring the taste of food on her tongue — something she hadn’t been able to do for two decades.
After surgery, Ms Thuy could open her mouth and converse with her doctor.
Seeing the smile on Ms Thuy’s face after 23 years brought indescribable joy to her family and the entire medical team at FV Hospital.
“After over 20 years of being unable to open my mouth, now that the surgery is over, I feel like I’m living a second life. I can go home to hug my daughter and express my gratitude to my parents and siblings for contributing to my treatment. I am grateful to the doctors for their successful surgery, giving me back a normal life where I can eat and drink easily like everyone else,” Ms Thuy said enthusiastically, expressing her gratitude for life’s simple things before leaving the hospital.
During her final examination before discharge, Dr Tung noted that Ms Thuy would continue to be monitored for outpatient dental treatment at the hospital. She would also need prosthetic facial appliances, such as prosthetic eyes and ears, and scar revisions to help restore the aesthetic appearance of her face. Mr Minh, her husband, mentioned that despite their difficult circumstances, they would try their best to continue treating his wife to help her achieve happiness with her appearance.
Nguyen Thanh Tung, MD, PhD and his team perform outpatient dental treatment for Ms Thuy.
