Abstract
We report a case of lower gingival carcinoma undergoing vagus nerve stimulation （VNS） therapy for intractable epilepsy. The patient was a 65-year-old man. He was referred to our hospital because of pain in the left mandibular gingiva. His medical history was secondary epilepsy due to sequelae of cerebral hemorrhage, which was difficult to control with drugs alone, therefore, he was treated with VNS therapy. The left mandibular gingiva had a surface papillary mass measuring 30×20mm. Based on biopsy and imaging examinations, a diagnosis of lower gingival carcinoma （SCC, T2N0M0） was made. Subsequently, he underwent a left mandibular segmentectomy and free fibular flap reconstruction, including left neck dissection （Level 1-2）. VNS was in the Level 3 area and was not exposed to the operative field. Because of VNS, he could not undergo an MRI or use of an electric scalpel. After the operation, we confirmed the validation of VNS with the manufacturer. Three implants were placed in the reconstructed bone 1 year and 1 month after the operation, and implant overdenture was performed. About 3 years have passed since the operation, and there is no evidence of recurrence or metastasis.
