Any appearance defect especially the one that is difficult to hide cause not only physical pain and discomfort to a patient but mental pain as well. So when one succeeds to find a way for overcoming the problem it’s both doctors and patients who are satisfied with consequences.
The hardest operation dealing with traumas and injuries consequence is a common routine of oral and maxillofacial surgeons. But sometimes they meet with cases that need not only surgery skills but programmer, engineers, and even medical imaging specialist skills as well. As for conducting such kind of operations surgeons need temporal bone and jaw fragment prosthesis. Usually, the surgeons order it from foreign companies. But that was the first time when such prosthesis was made by Ukrainian masters in Ukraine enterprise.
"The patient who came to us had a noticeably visible defect - asymmetry, and deformity of the face, lack of a right auricle, and have an overbite , said Professor Andrey Kopchak, who led this multidisciplinary operation. - After additional examination methods: multispiral CT-scan of the skeletal bones, an ultrasonographic examination of the soft tissues of the maxillofacial area, selective arteriography of the branches of the aortic arch, computer modeling and also after diagnosing Goldenhar syndrome. We chose multi-stage treatment. We reconstructed the patient’s the cheekbone and arch, as well as a fragment of the mandible that was individualized with titanium implants. They were made with selective titanium laser sintering technology (3D metal printing), with a single-moment replacement of the soft tissues defects with autograft.This high-level operative treatment was conducted in oral and maxillofacial surgery and dentistry center of Kyiv District clinical hospital. As they needed a highly-skilled professional from different fields: oral and maxillofacial surgeons, vessel and plastic surgeons, neurosurgeons. Scientists of Bogomolets National Medical University and Zaporizhia State Medical University: prof. A.V.Kopchak, docent O.M. Mishchenko, docent Yu.V.Chepurny, microvessel surgeons S.V. Ryabchun and V.V. Khalday performed a quite delicate work. In the nearest future, the patient will have to withstand many plastic operations and a long rehabilitation.
"In this case, we have Goldenhar syndrome that is congenital but quite rare disease",admitted professor Kopchak.But there is a quite big necessity in performing such kind of operations considering military activity in East part of Ukraine. Because around 30 percent of military injuries are facial injuries. This fact means noticeable deformations and defects. Not even mentioned the fact that such operations could and should be conducted for reconstruction the defects of cancer treatment and elimination of many other injuries, for example, domestic injuries and car accident injuries.
"This case is unique not only because of its multidisciplinary",added an Associate Professor of Surgical and propaedeutic dentistry of ZSMU, president of ІCOI Europe-Ukraine-The the main point that individualized titanium implants for the operation were made with selective laser sintering of titanium technology (metallic 3D printing of ultra-high accuracy) in Motor-Sich manufactory, Ukraine. This complex task was complicated by the leading specialists of the enterprise under the leadership of P.D. Zhemanyuk. By the way, our university has many years of experience of successful cooperation with Motor Sich company: that includes the constructing of an endoprosthesis for replacement hip joints that is widely used by orthopedists nowadays. That let Ukraine medicine to take a new level of worldwide technologies.
23 September 2019