Monday, May 14, 2007

Direct Dimensions Aids Johns Hopkins in Rebuilding Soldier's Nose

In October of 2007, Johns Hopkins University anaplastologist Juan Garcia, M.A., approached Direct Dimensions with a unique and timely project: to aid him and a team of medical staff at Johns Hopkins in creating a new nose for Senior Airman Michael Fletcher, a soldier who had been injured while stationed in Iraq. Using the Konica Minolta 9i laser scanner, the DDI team was able to scan a model sculpted by Garcia, and the resulting data was used to produce a new, fully-functional nose.

Fletcher was injured in August 2005 when his Humvee flipped over on a highway near Camp Bucca in Southern Iraq. While his body armor was able to protect most of his torso from being crushed, Fletcher lost his left arm and was left with a disfigured midface as well, including his nose. Despite many complications and over 40 hours logged in surgery, Fletcher decided against a detachable prosthesis and decided instead to work with Johns Hopkins to rebuild his nose. The reconstruction would be one of the most complex ever accomplished by Hopkins staff, requiring not only the best surgical expertise, but convincing aesthetics as well. Enter Juan Garcia, a medical illustrator specializing in facial prosthetics. He took a silicone impression of Fletcher’s damaged nasal area, and from the silicone impression made a stone model upon which he could sculpt Fletcher’s new nose. Using photographs of Fletcher before the accident for reference, Garcia spent over two hours carefully sculpting a new nose from hot wax that was then fitted to the stone model.

Once the wax nose and the stone model were fitted together, the results were scanned by Glenn Woodburn on-site at Direct Dimensions, using the Konica Minolta 9i laser scanner. This scanner provides a high-speed and high-accuracy scan that is ideal for digitally capturing organic shapes. Most often used for reverse engineering purposes, the Minolta 9i was used to scan Garcia’s nose model because it is ideal for capturing medium to large objects while retaining accurate color data. This was not the first time that Garcia had worked with Direct Dimensions-- previous collaborations produced several prosthetic ears and functional nose pieces, as well as research data for the creation of prosthetic hands.

After the completion of the digital nose guide, the resulting data was sent to the Berger laboratory at the United States Army’s Aberdeen Proving Ground, which is located in Gunpowder, Maryland. The nose was fabricated into a clear plastic model, which was then attached to Fletcher’s face. It was this plastic model that was used as a base for Fletcher’s final reconstructive surgery. Lead surgeon Patrick J. Byrne, M.D., and his team used Fletcher’s own bone, cartilage, skin, arteries and veins to reconstruct the nose, which is fully-functional. His last sutures were removed on May 2, 2007, and any further minor sculpting and contouring procedures will be done at an outpatient clinic.

More On This Story:

DDI on CNN: Direct Dimensions Helps Rebuild U.S. Soldier with 3D Imaging Technology

Feature report on CNN, Anderson Cooper 360° at 10 p.m. ET, Monday, May 14. Two-part series on CBS-WJZ in Baltimore on the 11 p.m. newscast, also on Monday, May 14 and Tuesday, May 15.