Craniofacial reconstruction

Posted on 31 July 2012

Meet our expert, Dr Dale Howes, a prosthodontist at Mediclinic Morningside. Part of a multi-disciplinary team, Dr Howes, together with maxillo-facial and oral surgeon, Dr Greg Boyes-Varley, are bringing new hope to patients who’ve been severely disfigured by facial tumours or traumatic injury, such as gunshot wounds. He works at the PI Brånemark Institute at Mediclinic Morningside, which is one of only 12 osseointegration centres globally and the only one in Africa.

A tumour in my face has left me quite disfigured. Is there hope of looking normal again?
Yes, there is hope and it’s thanks to the use of a simple screw, which revolutionised surgery back in 1956 when it was discovered that titanium, when inserted into bone, was not rejected by the body. This process of implanting titanium into bone to give structure where bone is missing has meant that patients have been able to regrow bone damaged by tumours or trauma.

How does osseointegration work?
When a titanium screw is inserted into bone it creates a bridge to which the bone cells attach themselves and this acts as a permanent foundation for prosthetic reconstruction. The word osseointegration comes from the Latin ‘os’ for bone and ‘integrate’, meaning to make whole.

How common are facial tumours and what is the outlook?
Tumours in the face and head area are only a small percentage of those found in the rest of the body. About 4 500 new South African cases crop up a year. Identifying the tumour as early as possible is key, but the mortality rate is around 40% to 60% depending on the type of tumour.

Is osseointegration used in other parts of the body?
Osseointegration is used in a range of medical disciplines and has helped many patients, including amputees and the hearing impaired. In the long term, the Morningside centre plans to extend osseointegration into the field of limb and digit restoration.

If you’d like to know more about craniofacial reconstruction, please post your questions here or on our Facebook page. 

Published in Surgery

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