New York Eye and Ear Infirmary of Mount Sinai Surgeons Perform Nose “Transplant” for Injured Boy
For the first time in the United States, a patient has undergone a complex and intricate series of surgical procedures to implant a fully functional 3D printed model of a nose after a tragic accident disfigured his face. The procedures were performed at New York Eye and Ear Infirmary of Mount Sinai (NYEE).
"The procedure is akin to a ‘nose transplant’ in that we were able to replace the nose with a functional implant,” said lead physician Tal Dagan, MD, Associate Adjunct Surgeon at NYEE. “This procedure may be a breakthrough in facial reconstruction, because the patient will never have to deal with the standard issues of transplantation, such as tissue rejection or a lifetime of immunosuppressive therapies."
The patient, a 14-year old boy from the Marshall Islands, flew halfway around the world to New York with the help of Canvasback Missions, Inc., a nonprofit organization that brings health care and health education to the islands of the Pacific, giving him a second-chance for a normal life. At the age of 9, the patient had a tragic accident where he fell onto a live power line, severely burning his entire face. Doctors in the Marshall Islands were able save his life, but he was left with severe disfigurement caused by the loss of his nose.
In early February of this year, the boy underwent the first of five surgeries needed to rebuild his nose. The first operation, which occurred in the Marshall Islands, involved inserting expanders under the remaining skin of his nose. The expanders worked to create room under his skin for the reconstruction procedures in the United States.
While the expanders were in, Dr. Dagan and a team from Oxford Performance Materials, Inc. (OPM), a leading advanced materials and additive manufacturing (3D printing) company, went to work creating a 3D printed facial device that would replicate a natural nose in appearance and functionality. Unlike a standard implant, the three-dimensional device was created using sample models taken from the noses of the patient’s close family members to recreate the most natural and culturally appropriate graft. It also allowed the facial plastic surgeons to rehearse the complex procedure and create a custom operation to minimize complications.
The initial procedure at NYEE also utilized new laser-based technology that allowed Dr. Dagan and his colleague Grigoriy Mashkevich, MD, Assistant Professor of Otolaryngology, Division of Facial Plastic & Reconstructive Surgery at NYEE, to scan the skin surface of the patient’s face to visualize the blood vessels feeding the skin and assess whether the skin was healthy enough for reconstruction.
With the use of tissue and blood vessels harvested from the patient’s thigh, Dr. Dagan and Dr. Mashkevich completed an initial 16-hour procedure that also included removing large amounts of scar tissue from the patient’s face, inserting the graft, and reconstructing the skin over the new 3D implant.
During his stay in the United States between June and October, the patient underwent several successful surgeries and follow-up outpatient exams, resulting in a full reconstruction of his nose. The implant is permanent, flexible, and will not need to be replaced as he continues to grow.
"We believe that this procedure will allow the patient to live a happy and productive life,” said Dr. Mashkevich. “We also hope that this approach will be a viable option for others with severe facial deformities that require reconstructive surgery."
Canvasback Missions, Inc. provided the necessary funding for the patient and his mother to travel to and stay in the United States during his medical care. NYEE, Dr. Dagan, and the Visiting Nurse Service of New York, provided the medical care and equipment for the case.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 18 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Gastroenterology/GI Surgery, Geriatrics, Nephrology, and Neurology/Neurosurgery, and in the top 50 in six other specialties in the 2018-2019 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 11th nationally for Ophthalmology and 44th for Ear, Nose, and Throat. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and South Nassau Communities Hospital are ranked regionally.