Cancer patient in world-first facial prosthetic made with smart phone
A cancer survivor has become the first person to receive a 3D printed face prosthesis made with a smart phone after a tumour ravaged a hole in his cheek.
Carlito Conceiçao, 54, from Sao Paulo, was diagnosed with upper maxillary carcinoma, an aggressive form of cancer in the upper palette of the mouth, in 2008.
The cancer was rapid and destroyed facial tissue on the right side of his face and half of the roof of his mouth, as well as damaging his throat.
Life-saving surgery halted the spread before it reached his brain, but when the tumour was removed it left a giant hole.
The married father-of-two lost his right eye socket and part of his nose, sending him into depression.
In February, he was offered the ground-breaking procedure which uses a smart phone for photogrammetry to build and print a 3D image of the missing part of his face.
The hand-finished silicon prosthesis has transformed his life by restoring his self-esteem.
Carlito said: “My first prosthesis was fragile, poor quality and kept falling off because it was held on by glue. I felt totally disfigured and I looked terrible.
“I lost all my confidence and fell into a deep depression.
“I couldn’t work and became a recluse because people would stare and point whenever I went out. I used sunglasses to cover up the area most of the time.
“I was so impressed by the result of the new one, I cried when they fitted it.”
Dr Rodrigo Salazar, a Peruvian dentist and specialist in oral rehabilitation, who is doing his PhD at the Paulista University (UNIP) in Sao Paulo, has been spearheading the project for two years.
He said: “Brazil doesn’t have the resources to equip all of its clinical centres with high-end technology.
“So, we’ve developed an alternative and simplified low-cost procedure that captures patients’ facial anatomy and generates physical working models, giving us the equivalent results to prostheses produced on state-of-the-art equipment that costs hundreds of thousands of pounds.”
Dr Salazar used a free app called Autodesk 123D Catch was downloaded onto Salazar’s smartphone, which turns photos into 3D models.
He took 15 snaps of the trauma area in a planned sequence at three different heights.
He said: “The rational for using a smartphone is that all modern mobile devices have an integrated accelerometer and a gyroscope sensor, which are automatically run by the application to guide the operator’s 3D position during the photo capture sequence.”
The photos were uploaded and converted into a virtual model of Carlito’s face.
Salazar said: “We mirrored the healthy side of Carlito’s face then digitally sculpted it to fit the trauma side.”
The prototype of the patient’s face was then created on a low-cost printer. This mould was used to make a new silicone prosthesis for Carlito, which was hand-finished by volunteer clinical artists who added skin colours, texture and realistic wrinkles and affects to give a natural looking fit.
The artificial attachment was fitted with magnets that lock onto three titanium screws embedded under Carlito’s eyebrow.
Dr Luciano Dib, a maxillofacial surgeon who is involved in the project, performed the two-hour osseo-integration operation.
He said: “This is a well-established procedure for anchoring cranio-facial prostheses.
“It means wearers can confidently go to the beach, take a shower, go to the gym and run without fear of the prosthesis falling off. And they can take it off at night to clean it.”
The cutting-edge procedure, called Plus ID, is being pioneered by a team of physicians in Brazil and America as a feasible low-cost alternative for clinical centres that do not have access to high-cost technology.
Under the Plus ID project, doctors took less than 20 hours to create the prosthesis for Carlito’s face.
Anaplastologist at the University of Illinois Hospital of Health Sciences System at Chicago, Rosemary Seelaus, is part of the project.
She said: “Our aim with the Plus ID project is to address a multi-dimensional problem that’s global.
“Head and neck cancer is a huge public health issue around the world and many people don’t have access to rehabilitative care when the disease mutilates the face.”
According to 2014 research by the Union of International Cancer Control, there are more than 550,000 cases of head and neck cancer incidences with around 300,000 deaths every year.
As an anaplastolgist, Seelaus is one of only a few hundred experts in the world who has the skill-set of a clinician, artist and engineer to make external artificial parts from start to finish.
She added: “Our intention is to train as many people as possible to make this affordable and practical technology accessible throughout South America, Africa and Asia and in remote areas of the world where people have minimal health care services.”