A patient’s nose reconstructed on her forearm using a 3D printed biomaterial

A few years ago, following chemo and radiotherapy treatment for cancer of the nasal cavities, Carine lost the front part of her palate, but also a large part of her nose. “It healed me, but it also damaged me”, explains this mother. On several occasions, surgeons from the ENT and cervico-facial department of the Toulouse University Hospital and the IUCT-Oncpôle attempted to reconstruct his appendix using skin flap grafts. Without success. Impossible for as much to turn to the graft of a donor, the catch of immunodepressants being a factor of recurrence of cancer. “I have been cloistered at home for the past eight years. When you are sick, you isolate yourself and the face is what you see first, ”says this 50-year-old Tarnaise.

While waiting to find a solution, she adopted an external silicone nasal prosthesis. But she also had a lot of trouble supporting it, she couldn’t hold it. His doctors therefore attempted a completely innovative “last resort” intervention: a complete nasal reconstruction using a 3D printed biomaterial. This tailor-made device was designed by the Belgian company Cerhum based on scans taken before the patient’s cancer treatment.

The future nose “nursed” on his forearm

Once made of hydroxyapatite, a synthetic porous material, last July it was implanted on the patient’s forearm, where the skin is very thin, almost identical to that of the face where radiotherapy had damaged the skin. .

“It’s like a support that gives shape. The skin lives around, the tissues go inside the biomaterial which is filled by the cells of the patient’s body. The custom-made 3D printed biomaterial was placed under the skin of the forearm so that it could be colonized and she kept it there for two months”, explains Professor Agnès Dupret-Bories, ENT surgeon at the IUCT-Oncopole.

During this period, the patient went regularly to the Oncopôle to check the progress of this “nursing”, to see if there was any problem of infection, if the vascularization was going well. Last September, once the colonization of the support was complete, the second operation could take place.

“I find the smells, I come out, I live again”

With Dr. Benjamin Vairel, the surgeon was able to remove the graft to implant it under a microscope on the patient’s face, using the blood vessels of the fifty-year-old’s temple to irrigate it. To repair the part of his forearm where the biomaterial had been implanted, a skin graft taken from his thigh was performed.

A success. Ten days after this operation, a first of its kind, Carine was able to leave the hospital. Today, she breathes “a little better”, her nose is swollen but she has no redness. “I also find the smells of my garden, I can go out, I come back to life. It’s miraculous, this biomaterial was my last resort and I salute the research and the work of the doctors who helped me to hold on”, insists this enthusiastic patient.

She will still have to undergo a new operation to perform touch-ups on her nose, as well as dental reconstruction. But thanks to the support of her husband and her son, to her “steel morale”, she is already thinking about the future. And also to all that this new technology could bring to those who go through the same ordeals as it, “to the hope that it can arouse, because you always have to have some when you have cancer”, Carine concludes enthusiastically. .