Malignant peripheral nerve sheath tumours are extremely rare tumours arising in peripheral nerves. Only 17 cases involving the trigeminal nerve have ever been reported. These tumours have a very poor prognosis and very high rates of recurrence and metastases. Their recommended treatment involves complete tumour resection followed by radiation. This can be problematic in the head and neck region. We present a clinical case involving a 33 year old female patient presenting with a slow growing exophytic mass of the anterior maxilla.Incisional biopsy and subsequent histological examination revealed a diagnosis of a malignant peripheral nerve sheath tumour. Surgical resection involved a complete maxillectomy, rhinectomy, and resection of the upper lip and aspects of the left and right cheeks. Reconstruction of the subsequent defect incorporated the placement of 4 zygomatic oncology implants to aid in retention of a facial prosthesis. These implants, however, were subsequently lost so it was decided to manufacture an anatomical model of the hard tissues via 3D printing. This model was used to design and manufacture a titanium frame (customised implant) for the patient, which was then fixated and secured intra-operatively with 21 cortical screws. A maxillary denture and silicone facial prosthesis were also made to fit onto this frame. This is the first known case where additive manufacturing, via the use of rapid prototyping and 3D printing, was employed to manufacture a facial prosthesis.

No abstract

Myoepithelial carcinomas are rare malignant tumors arising from salivary glands. They most commonly involve the parotid and minor salivary glands but may also occur in the submandibular glands. These tumors can become extensive, causing bony expansion and destruction. A 31-year-old man with a large swelling on the left side of the face is presented. Histologic examination of an incisional biopsy confirmed a diagnosis of a myoepithelial carcinoma arising from the left submandibular salivary gland. After tumor resection, the patient's mandible was reconstructed with a customized mandibular framework produced by means of 3-dimensional (3D) laser sintering. This approach significantly reduced cost, advanced surgical procedures, and operating room time, which is of great benefit in a developing country like South Africa.

Complete congenital arhinia is a rare embryonic disorder of unknown etiology. This is a clinical report of prosthetic nasal rehabilitations done in the early childhood and adolescent stages of a patient with complete congenital arhinia. Additive manufacturing techniques for creating pre-surgical planning models to assist in the creation of new nasal passages is also described. These rare cases can be successfully rehabilitated if patients are sufficiently motivated and there is meticulous planning and collaboration from a multidisciplinary team.

Surgical and prosthodontic restoration of the midfacial region following tumor resection has always posed a considerable challenge, as this area serves crucial functional and esthetic roles. Being diagnosed and subsequently treated for facial tumors can have an immense psychosocial impact on a patient, as the resulting defects are often disfiguring, and lead to an inability to masticate, swallow, and speak clearly. Provision of an immediate facial and dental prosthesis at the time of surgery can limit these side effects and help reduce mental duress on these patients and their families, as well as aid in the process of rehabilitation. Rapid prototyping (RP) and 3D printing, as this paper shows, assists presurgical planning of the tumor resection, as well as the manufacture of maxillofacial and dental prostheses. Often these defects are extensive, so prosthesis retention is aided by zygomatic implants placed at the time of surgical resection. When placed at this time, and prior to radiation therapy, these craniofacial implants have improved survival rates. Thus, this treatment modality can improve postoperative recovery considerably, while at the same time allowing for cleaning and monitoring of the resected site for tumor recurrence.