Bengaluru: Doctors in Bengaluru have brought about a miracle in the life of a young Yemeni lad, who lost his mandible (lower jaw) in a war back in his homeland. The doctors pulled off this unimaginable feat by naturally reconstructing a replacement jaw by harvesting tissue from his hip bone and stem cells.
Hussain was only 17-years-old when he lost his mandible in an explosion. Owing to this, he was unable to close his mouth and had difficulty swallowing due to lack of skeletal support. Prior to the procedure in Bengaluru, he had undergone nine procedures across the globe, where tissue from various parts of the body was harvested to reconstruct his jaw. Unfortunately, the procedures failed due to infection. A few years later, Hussain was referred to Manipal Hospital here in Malleswaram by another Yemeni war victim who is undergoing treatment at the hospital.
Here, a team of consultant Facio Maxillary surgeons, Dr Nisha Shetty and Dr Satyajeeth Dandagi, worked with Osteo3D, a Bengaluru-based medical 3D printing company, to make a new mandible for the now 21-year-old Hussain.
Speaking to Newskarnataka.com, Dr. Nisha, a native of Mangaluru, said, "When he (Hussain) came to us, he didn't have many donor options. Usually, we use the person's own bone to create the missing part, but then, in this case, the options were very few as various bone tissue from various parts of the body was harvested during those nine surgeries."
"The only viable bone tissue remaining, that could be harvested was in his hip. We could not use both sides of the hip as in case the boy suffers another mishap in the future, there should be some harvestable bone tissue available. So we kept one bone graft site for any other emergency," she added.
Osteo3D helped the doctors design a mandible framework, a sort of hollow mould, to be used to create the new jaw. Into this 3D printed titanium framework, the doctors filled bone tissue harvested from Hussain's hip and introduced his stem cells to grow the new mandible.
The young lad had to wait three months for the mandible to grow, but the end result was worth the wait.
"The whole planning and procedure took three months. To create the stem cells it took us about three weeks and then to get the 3D printing planning done, it took more than a month because we kept making various designs and rejecting them. Mr Deepak from Osteo 3D helped us a lot with this. The surgery, however, took 12 to 14 hours and was done by me and Dr Satyajeeth Dandagi," she said.
When asked if there were other such procedures done, the doctor said that, to her knowledge, there were no similar cases that were documented. "We researched a lot before attempting this procedure, but we were not able to find any similar case that was documented. The closest case we could find were infection related. We had even considered cadaver transplant, but rejection is such cases is very high and we decided not to take the risk because he (Hussain) is very young," the doctor explained.
Asked about Hussain's condition, Dr Nisha explained that although he has no teeth on the lower jaw yet, Hussain is able to chew and eat food. For now, however, he can't bite bones and the like, but he can eat chicken and things like that. The doctors have told him that he can go back home and return after a year so that they can put teeth on the lower jaw. It takes about a year for the bone to mature, so they will have to wait till then to place teeth on the mandible.
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