Getting a cancer diagnosis is never a good thing, and even if you beat the disease, there can be lasting health effects. 53-year-old HGV driver and father Stephen Waterhouse, who lives in the UK, was told he had throat cancer in his right tonsil nearly a decade ago. Chemotherapy and radiotherapy helped him conquer the potentially deadly disease, and he was declared cancer-free three years ago. But unfortunately, while the radiotherapy helped kill the cancer, it also began to disintegrate his jawbone, which left Waterhouse at risk of even further complications. He sought help from the Royal Stoke University Hospital, part of the NHS University Hospitals of North Midlands (UHNM), and left with a new jaw bone, thanks to 3D printing technology.The NHS Trust purchased a £150,000 3D printer two years ago, and Daya Gahir, a consultant in maxillofacial and head and neck surgery with Royal Stoke University Hospital, used in-house software to create a 3D printed mold. He was then able to manufacture a new jaw for Waterhouse, using bone that was taken from his fibula. A hospital in Malaysia used Materialise 3D software last year to perform this same type of surgery.
“We do at least 40 major head and neck reconstructions per year,” Gahir explained. “Around 10 to 15 cases will be done in this way using the printer. Some of the leg bone was taken then reshaped, as you have to replace bone with bone. We took away some of the skin from the legs as well and replanted it back into the neck. A face is not easy to reconstruct, it is intricate. If you leave 7cm of the leg bone on either side, you can take the rest as it carries only about 20 percent of the body weight, maximum.”
Waterhouse started having significant problems with his jaw last year, and he clearly came to the right place for the 12-hour-long reconstructive surgery.
“Eventually my cheek would have broken,” Waterhouse said. “The staff have been brilliant. The aftercare is just as important as the operation and with that they have been absolutely superb. I can’t fault the care.”
The aftercare Waterhouse is referring to is extensive – patients have to spend five days in the high dependency unit after surgeries like this. If that weren’t enough, they also face up to two weeks in a different ward, where instead of enjoying Jello and soup, they are fed food through their nose.
New software at the hospital meant that the whole process, from designing and building the necessary surgical tools to performing the surgery itself, was completed in-house. The Royal Stoke University Hospital is the only hospital in the UK that has the kind of technology necessary to make a new jaw out of leg bone, which is beneficial in terms of saving both time and money.
“You can’t drink water. Because of my radiotherapy too, I have reduced saliva glands, so my mouth was dry anyway. They couldn’t even put a swab in for a while,” explained Waterhouse. “But I am so pleased with the results – you can’t tell the difference between the two sides of my mouth.”
Mr. Gahir said, “In each case of this we are saving about £11,000, but it’s the results that are paramount. If you put the bone in the right place, you can have dental implants and so on – the surgery has an impact on future treatments. If patients couldn’t have it done here, they would have to be sent to Germany for it. Not only is that expensive, but it’s a waste of time too. Cancers don’t wait, they keep growing. It’s better for the patient too as they don’t worry as much.”
According to UHNM, surgeons and staff in the oral and maxillofacial department are also using the hospital’s 3D printing technology to manufacture patient-specific surgical models. A few years ago, surgeons in India used 3D printed models by Osteo3d to help remove tumors from a man’s jaw. At Royal Stoke University Hospital, an accurate jaw model can be 3D printed in days, which gives surgeons time to prepare for risky procedures.
“From the moment a cancer patient is diagnosed as having a tumour which is growing into their jaw, we can get work on producing our personalised 3D models,” said Mr. Gahir. “In the past, our estimations would have been much less accurate and therefore we can now carry out this surgery with much more precision. Myself and a number of colleagues have attended training courses to help understand the technology better, and we hope that one day this is a procedure that will be rolled out more widely across the NHS.”
Patient-specific 3D printed models can also help get patients off the operating table much faster, which means that the recovery can generally be faster as well. Discuss in the 3D Printed Jaw forum at 3DPB.com.[Sources: The Sentinel, The Mirror, University Hospitals of North Midlands]
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