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Pioneering more efficient and accurate
Pioneering more efficient and accurate digital prosthetics through computer-aided technologies
Maxillofacial Prosthetists, Reconstructive Scientists and Dental Technicians are dedicated to reconstructing head and neck, and body defects following trauma, disease or congenital abnormality. Blending art with science, the techniques they use require an intimate knowledge of the materials, design methods and manufacturing processes that are required to create lifelike prostheses made of artificial materials.
For over twenty years, Morriston Hospital’s Maxillofacial Laboratory team has collaborated with Cardiff Metropolitan University to pioneer more efficient, reliable and accurate head and neck reconstruction methods.
Technologies, organisational challenges, and regulatory conditions have also evolved significantly over the last two decades. Close co-operation between healthcare providers, researchers, industry partners and regulatory bodies are still required to ensure sustainable development of in-hospital custom medical device design and manufacturing service.
Facial prostheses – immediate nasal reconstruction
The teams at Cardiff Metropolitan University and Morriston Hospital have published extensively on how computer-aided design technologies can be used in facial prosthetics. Rhinectomy involves surgical removal of all or part of the nose, usually as a result of cancer. Nasal prostheses restore contours and are designed to blend seamlessly into the surrounding anatomy using thin edges that flex with facial expressions. Prostheses are normally made around six weeks post-surgery, leaving the patient without a nose until this time. Recent innovations mean patients are now offered a temporary prosthetic nose immediately after surgery. This eases the impact of losing a nose and creates a transition to the definitive prosthesis fabricated further along in the recovery process.
Computer aided design software is used to create a digital nasal prosthesis prior to surgery. Low-cost 3D printing methods are then used to create a mould tool, around which a colour matched sheet of silicone is formed in layers that mimic natural skin tones. Following sterilisation, prostheses are either stitched to the patient’s face or worn on glasses until post-surgery swelling reduces and treatment is completed.
Custom breast prostheses
The COVID-19 pandemic has been highly disruptive to many areas of healthcare, particularly surgery. There are now a high number of women awaiting surgical breast reconstruction following mastectomy, which has led to research, originally published in 2010, being deployed to meet the massive increase in demand for custom external breast prostheses.
Morriston Hospital is the only NHS service offering women the opportunity for a custom breast prosthesis. Custom prostheses offer improved comfort over non-custom, which is particularly beneficial for large breast cases or complex anatomy. The techniques used were developed through collaboration. Threedimensional surface scanning is used to capture the remaining breast form and/or mastectomy region. Computer aided design is then used to create the perfect shaped prosthesis. A pattern is then 3D printed, before being made into a long-lasting plaster mould. The final prosthesis is moulded in lightweight foamed silicone using specially developed techniques.
