Toulouse-Oncopole University Cancer Institute performed a complete reconstruction of a patient’s nose, using a 3D printed synthetic implant. It was first implanted on his forearm before taking his place on his face.
True teamwork between the ENT and head and neck surgery teams of the University Hospital of Toulouse and the Claudius Regaud Institute enabled this complete nasal reconstruction from a custom-made synthetic graft. A two-stage surgery performed by Pr Agnès Dupret-Bories and Dr. Benjamin Vairel.
The patient from Toulouse is a 50-year-old woman who had nasal cavity cancer. In 2013 she was treated with chemo and radiotherapy and due to this treatment she lost most of her nose.
For four years, he had to deal with many failures of nasal reconstruction using a skin flap graft. The team then offers her the use of a facial prosthesis, which she does not support.
Then comes the idea of this synthetic graft tailored for this woman who has failed the classical reconstruction. “He was very enthusiastic“, says Professor Agnès Dupret-Bories. The ENT and head and neck surgery team at the University Hospital of Toulouse is starting to collaborate with Cerhum, a Belgian manufacturer of medical devices specializing in bone reconstruction.
“It is a bespoke implant made of biomaterial, which is a scaffold of pores to be colonized by the patient’s body.“, explains Professor Agnès Dupret-Bories. The shape of the implant is made using old scanners dating back to before the patient’s medical treatment and her prosthesis. After several weeks of exchanges between the Toulouse Oncopole team and the Cerhum company, the medical device is ready.
It is first implanted on the patient’s forearm for two months becauseshe “no longer had skin and since the region of the nose was irradiated by radiotherapy, this area was therefore less vascularized“, Agnès Dupret-Bories points out.
“Once the colonization of the medical device has appeared complete, the graft, with the surrounding skin, is then implanted on the patient’s face.explains the Professor. Then, under a microscope, I create connections between the blood vessels of the skin of the arm and those of the temple.“
Today, one month after the implant, he can breathe with his new nose, but “the skin is not sensitive. It is an aesthetic and social reconstruction “. A second surgery will be required to make cosmetic changes.
This feat is a true technological and surgical innovation. A first with this total reconstruction with this type of porous biomaterial. “There was no solution on the reconstructions of such large parts of the face. With this device, we hope to be able to offer a satisfactory result in two interventions“, Concludes Agnès Dupret-Bories.
