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.

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