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MAXILLOFACIAL
RESTORATIONS:
A maxillofacial prosthesis is a man made
replacement for parts of the face damaged by injury or disease, such as
cancer.
Facial prostheses themselves are anything but new. The first known
facial prostheses were metal noses, invented and affixed to the face by
the French dentist Pierre Fouchard in the 1700s-often in patients with
syphilis. President Grover Cleveland was diagnosed with tumors of the
maxilla, or upper jaw bone, and was successfully treated with a
prosthesis; he was able to speak before Congress following a speedy
rehabilitation. Sigmund Freud likewise was diagnosed with a tumor of the
maxilla, but didn't fare as well. His original diagnosis was squamous cell
carcinoma, a serious skin cancer; after thirty-three surgeries and a
prosthesis so troublesome he referred to it as "the monster," Freud died
from inoperable cancer.
Today, maxillofacial prostheses are infinitely more successful. Artfully
crafted from silicone, they are indistinguishable from real skin. They are
customized for each patient, down to the brown age spots found on many
older patients. From wrinkles around the eyes to the redness of Terry
Donelon's ears, modern prostheses are amazingly lifelike. Doctors will
even fashion a "winter ear" and "summer ear" for farmers and others who
spend a good portion of their warm-weather days outdoors, so the
prosthesis will match the patient's tanned real ear.
One of the most common and easily remedied craniofacial deformities in
children is a cleft lip, cleft palate, or both, occurring once in every
700 to 800 births. If the cleft condition is not repaired, the child
probably will not eat, speak, or hear properly as he or she grows. While a
cleft lip and palate are congenital conditions, typically able to be
corrected surgically without a prosthesis, many situations require a
maxillofacial prosthesis.
Some children are born with no ears, or with incomplete ears or "ear
tags." One teenager lost his ear in an auto accident; an adult patient had
his ear bitten off in a bar fight. Probably the most common need for
maxillofacial prostheses among adults is in cancer patients; ninety
percent of all head and neck tumors are squamous cell carcinoma. That kind
of cancer can and does occur anywhere-in nose tissue, on the scalp, in a
lip-and surgical removal often leaves a gaping hole. Today, that hole can
be replaced by a prosthesis to restore normal breathing, hearing, speech,
eating, and appearance.
The implant system involves several stages. The doctor makes an impression
of the area-the remaining good ear, if the prosthesis is to be an
ear-using alginate, the same substance dentists use to make impressions of
teeth. A stone cast is made from that impression and the prosthodontist
forms a wax model of the missing ear. The patient is ready for his or her
first "fitting" to check the size and shape of the new ear. The model ear
is then processed into hard acrylic and other materials that can be seen
radiographically. A CAT scan is done with the new ear in place, showing
how much bone and soft tissue is present in relation to the desired
position of the ear. This allows for the surgeon to plan for the best
positioning of the implants and requires the prosthodontist and surgeon to
work closely as a team.
If you or someone you know is in need of
a maxillofacial restoration,
contact us today to find out how we can help you. |
