MEDICAL
Groundbreaking Surgery
for Jaw Reconstruction
Newcastle United football fan Tommy Innes has recently undergone reconstructive cranio-maxillofacial (CMF) surgery to remove a tumor from his lower jaw. The 10-hour long procedure took place at The Newcastle Royal Victory Infirmary (RVI), where Tommy works as an NHS electrician. Materialise worked with the surgical team involved in the complex CMF procedure, which involved replacing part of Tommy’s lower jaw with bone taken from his fibula. Tommy's case was included in an episode of the BBC's The One Show.
Image credits: BBC
Discovering the tumor
During a routine dental checkup, Tommy was surprised to discover he had a lump in his lower left jaw and the dental hygienist referred him to the Dental Hospital at the RVI. Mr. James Adams, the maxillofacial surgeon on the case, explained that although the tumor was benign, if allowed to develop it would not only become painful but could cause difficulty in speech and swallowing, lead to jaw weakening and potentially a fracture.
Essential roles of advanced visualization and Medical 3D Printing
The surgical plan involved removing the left side of the jaw and replacing it with a section of bone from the thin bone of the leg, the fibula. It also meant removing almost all of Tommy’s teeth in the lower left part of his jaw. As a result, he would need implant for cranio maxillofacial surgery and these were also planned on the leg bone before it was removed.
Image credits: BBC
DePuy Synthes’ TRUMATCH® CMF Solutions, that utilize Materialise 3D Printing technology, were used to plan and perform the surgery. Mr. Adams and plastic surgeon Omar Ahmed liaised with a Materialise clinical engineer, Charlotte Van Melkebeke, using ProPlan CMF software, to identify the precise location for the cuts and provide the 3D-printed surgical cut guides. During the surgery, the guides were used to ensure maximum accuracy for the resection and to make the screws holes match with the holes in the 3D-printed titanium plate, which was used to fix the section of leg bone onto the jaw.
Image credits: BBC
A big advantage of the 3D-printed plate, says Mr. Adams, is that it is already contoured to suit the patient’s anatomy and doesn't need to be bent, which is an extremely difficult thing to do, even in the best hands. Additionally, Mr. Ahmed reports that 3D visualization helped to ensure precise contact between the grafted section of leg bone and the jawbone. This contact is critical for the healing of the bone.
3D surgical planning for facial operations is a major advancement in plastic surgery. It enables advanced visualization of the cranium, with which surgeons can take facial symmetry into account when planning an operation. Symmetry is an important aspect of the human body, especially when it comes to the face. Knowing that they can look normal again is reassuring for patients' self-confidence.
New left jaw with dental implants
When dental implants are required in jaw reconstructions, a second procedure is usually required. Many patients tend to shy away from a having to go under the knife a second time but in Tommy’s case the surgeons were able to pre-plan exactly where to insert regular dental implants into Tommy's new jawbone, and already form a basis for replacement teeth before removing the section of fibula. Mr. Adams says: “What was unique about Tommy’s operation was the use of this revolutionary technology to plan our dental implants on the leg. Technology is making it quicker and easier for us to carry out these procedures accurately.
Image credits: BBC
Great results
Thanks to 3D planning and 3D-printed guides, a healthy blood supply to the lower jaw, facial symmetry and a good bite were achieved for Tommy. These are nothing short of excellent results and although Tommy's voice and the way he speaks may be a little different in the short term, his face remains a familiar face.
Materialise has once again contributed to making the world a better and healthier place, one patient at a time. Do you want to know more about how advanced visualization can greatly improve surgical planning and results?
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