'Will my 6-year-old daughter recognise me?' Dubai Filipino expat with facial tumour undergoes 3D-printed surgery

Will my little daughter recognise me? Will I be able to eat normally and resume my job at a coffee shop? Such worrying questions plagued Dubai-based expat John Michael Mauleon before he underwent a crucial surgery for his facial tumour.

But now, John is a relieved family man with a 3D-printed titanium jaw. A multidisciplinary team of doctors at NMC Royal Hospital, DIP, Dubai, treated Mauleon’s tumour using cutting-edge 3D technology and free flaps restoring both the facial appearance and function of his jaw.

The 32-year-old Filipino, a team leader at a coffee shop in Al Quoz, underwent surgery after facing a recurrence of a tumour in his right lower jaw. But Mauleon was filled with anxious questions about his family life, career, and future life until an innovative approach by the doctors not just gave him hope but those grappling with the devastating impact of these tumours.

His case was led by the hospital’s oral and maxillofacial surgeon Dr Bhushan Jayade and assisted by Dr Vikas Verma, consultant, plastic surgeon; Dr Adil Ali, specialist, plastic surgeon; Dr Ananth Pai, medical director, specialist general and laparoscopic surgeon and Dr Surjya Upadhyay, specialist anaesthesiologist.

The team deployed CT scans to assess the exact dimensions of the tumour and created an intricately detailed model while meticulously planning the precise amount of surgery required for its removal.

“Previously, surgical excisions of jaw tumours were more arbitrary, with decisions made in the operating room. This often led to excessive tissue removal and unsatisfactory facial symmetry, aesthetics, and function results. However, with 3D technology, we can now precisely plan the resection and accurately replicate the planned cuts during surgery using cutting guides,” Dr Jayade explained.

The integration of 3D technology with free flaps, a technique where bone, muscle, or skin tissues are taken from different parts of the body, allows for comprehensive reconstruction of the jaw. These tissues, along with their arteries and veins, are connected to ensure proper blood supply and restore functionality.

Dr Verma said that a free flap is the gold standard for reconstructing the facial defect after the resection of the tumour.

“Plastic surgery principles say, ‘replace lost tissues with like tissues’. Hence, we need bone, soft tissues, and skin to reconstruct the lost bone, soft tissues, and skin. In free flaps, we harvest the required tissues from a distant area like the thigh or the leg, along with its blood vessels. These are transferred to the receipt area, and its vascularity is restored by anastomosing the vessels with the vessels of the recipient area, using microvascular techniques. This is a very complex surgery requiring 5-6 hours and a trained team.”

Dr Jayade noted that 3D printing technology enables them to remove the necessary tumour tissues precisely and reconstruct the affected area with remarkable accuracy.

“The use of reconstruction plates shaped to match the removed part, along with the extrapolation of data from the opposite normal side, ensures exceptional cosmetic and functional outcomes. This transformative approach reduces operating time and delivers tremendous postoperative results, leaving the patient ecstatic.”

In the past five years, the hospital has successfully treated more than 50 patients with facial tumours, ranging from benign to malignant cases employing the integration of 3D technology and free flaps. This cutting-edge technique has also been used to address facial deformities resulting from trauma.

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