Gerald T Grant1, Peter Liacouras, Gabriel F Santiago, Juan R Garcia, Mohammed Al Rakan, Ryan Murphy, Mehran Armand, Chad R Gordon. 1. From the *3D Medical Applications Center, Department of Radiology, and †Department of Otolaryngology, Walter Reed National Military Medical Center, Bethesda; Departments of ‡Art as Applied to Medicine, and §Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore; and ∥The Johns Hopkins University Applied Physics Laboratory, Laurel, MD.
Abstract
INTRODUCTION: Current protocols for facial transplantation include the mandatory fabrication of an alloplastic "mask" to restore the congruency of the donor site in the setting of "open casket" burial. However, there is currently a paucity of literature describing the current state-of-the-art and available options. METHODS: During this study, we identified that most of donor masks are fabricated using conventional methods of impression, molds, silicone, and/or acrylic application by an experienced anaplastologist or maxillofacial prosthetics technician. However, with the recent introduction of several enhanced computer-assisted technologies, our facial transplant team hypothesized that there were areas for improvement with respect to cost and preparation time. RESULTS: The use of digital imaging for virtual surgical manipulation, computer-assisted planning, and prefabricated surgical cutting guides-in the setting of facial transplantation-provided us a novel opportunity for digital design and fabrication of a donor mask. The results shown here demonstrate an acceptable appearance for "open-casket" burial while maintaining donor identity after facial organ recovery. CONCLUSIONS: Several newer techniques for fabrication of facial transplant donor masks exist currently and are described within the article. These encompass digital impression, digital design, and additive manufacturing technology.
INTRODUCTION: Current protocols for facial transplantation include the mandatory fabrication of an alloplastic "mask" to restore the congruency of the donor site in the setting of "open casket" burial. However, there is currently a paucity of literature describing the current state-of-the-art and available options. METHODS: During this study, we identified that most of donor masks are fabricated using conventional methods of impression, molds, silicone, and/or acrylic application by an experienced anaplastologist or maxillofacial prosthetics technician. However, with the recent introduction of several enhanced computer-assisted technologies, our facial transplant team hypothesized that there were areas for improvement with respect to cost and preparation time. RESULTS: The use of digital imaging for virtual surgical manipulation, computer-assisted planning, and prefabricated surgical cutting guides-in the setting of facial transplantation-provided us a novel opportunity for digital design and fabrication of a donor mask. The results shown here demonstrate an acceptable appearance for "open-casket" burial while maintaining donor identity after facial organ recovery. CONCLUSIONS: Several newer techniques for fabrication of facial transplant donor masks exist currently and are described within the article. These encompass digital impression, digital design, and additive manufacturing technology.
Authors: Chad R Gordon; Srinivas M Susarla; Zachary S Peacock; Leonard B Kaban; Michael J Yaremchuk Journal: J Craniofac Surg Date: 2012-01 Impact factor: 1.046
Authors: Gabriel F Santiago; Srinivas M Susarla; Mohammed Al Rakan; Devin Coon; Erin M Rada; Karim A Sarhane; Jamie T Shores; Steven C Bonawitz; Damon Cooney; Justin Sacks; Ryan J Murphy; Elliot K Fishman; Gerald Brandacher; W P Andrew Lee; Peter Liacouras; Gerald Grant; Mehran Armand; Chad R Gordon Journal: Plast Reconstr Surg Date: 2014-05 Impact factor: 4.730
Authors: B Pomahac; J Pribaz; E Eriksson; D Annino; S Caterson; C Sampson; Y Chun; D Orgill; D Nowinski; S G Tullius Journal: Am J Transplant Date: 2011-01-07 Impact factor: 8.086
Authors: Maria Siemionow; Frank Papay; Daniel Alam; Steven Bernard; Risal Djohan; Chad Gordon; Mark Hendrickson; Robert Lohman; Bijan Eghtesad; Kathy Coffman; Eric Kodish; Carmen Paradis; Robin Avery; John Fung Journal: Lancet Date: 2009-07-14 Impact factor: 79.321
Authors: Dimitris Mitsouras; Peter Liacouras; Amir Imanzadeh; Andreas A Giannopoulos; Tianrun Cai; Kanako K Kumamaru; Elizabeth George; Nicole Wake; Edward J Caterson; Bohdan Pomahac; Vincent B Ho; Gerald T Grant; Frank J Rybicki Journal: Radiographics Date: 2015 Nov-Dec Impact factor: 5.333