RECONSTRUCTIVE SURGERY WITH 3D MODELING AND CUSTOM PROSTHESES: TREATMENT AND SOCIAL ADAPTATION

Nothing is more difficult for a doctor than to become a patient oneself. This happened to our hero: the emerging facial asymmetry and discomfort in the area of the right cheek and half of the nose forced military surgeon Sergey to seriously take care of his health. Intuition and experience suggested that delaying was dangerous. Examination confirmed the most serious concern — cancer of the right maxillary sinus. Sergey immediately underwent surgery, which was successful, but within a month, the disease made its presence known again — the tumor resumed growing. Chemoradiation therapy provided a six-month respite, but this August, the disease returned with renewed force. The pain increased every day, and the swelling on his face became noticeable even to the naked eye. Sergey’s colleagues could no longer help — all standard treatment methods had been exhausted.

The only hope remained high-tech surgeries with individualized prosthetics, performed only in certain institutions in our country. “The tumor had spread to the soft tissues of the cheek and the right half of the nose, destroying the walls of the right maxillary sinus, the lower orbit, and the alveolar process (the bony part of the jaw that forms the sockets for teeth),” says Dr. Mikhail Kropotov, Head of the Head and Neck Department at the A. Tsyb Medical Research Radiological Centre  — branch of the National Medical Research Radiological Centre of the Ministry of Health of Russian Federation, professor. “Despite the large-scale tumor process, interventions of this kind must be performed radically while preserving the aesthetic effect”. Two domestic prostheses were specially created for Sergey: the first replaces the lower orbital wall to maintain the normal position of the eye, and the second addresses the defect of the hard palate and the upper jaw gum. Thanks to this personalized approach and 3D modeling, the surgeons were able to accurately reproduce the necessary components.

“During the operation, we removed the tumor of the upper jaw along with the involved bony walls of the maxillary sinus, the floor of the orbit, a fragment of the upper jaw gum, and the right hard palate”, – says Pavel Spirin, a surgical oncologist of the department. “We also removed the lymph nodes on the side of the tumor to rule out regional metastases. Then we reconstructed the floor of the orbit using a custom-made prosthesis, securing it with metal structures to the nasal and zygomatic bones. A dental prosthesis was placed in the oral cavity, replacing the defect of the palate and gums along with the teeth.” These prostheses replaced the removed parts of the jaw, allowing for the highest possible quality of reconstructive surgery. Already on the next day after the operation, Sergey began speaking and eating on his own.

These prostheses replaced the removed parts of the jaw, allowing for the highest possible quality of reconstructive plastic surgery. Already the day after the surgery, Sergey began to speak and eat independently. Now he is preparing to return home and make plans. Sometimes the power of medicine is measured not only by technology but also by the people who, having gone through a trial, choose this difficult yet very important path — to continue treating others.