Defects in the head- and neck region are often seen as stigmatizing, might have functional consequences such as food-intake and speech and are sometimes felt to be aesthetically unpleasing. As such, congenital or acquired diseases such as facial palsy or schisis have great impact on individuals involved. Usually these patients are infants where the families are to be addressed as well, but next to them there is an overwhelming group of patients having sustained tumors in need for reconstruction.
We strive for the best possible solution for our patients presenting with these problems. This makes thinking outside the box necessary, since every patient is an individual with individual needs, expectations and challenges. This feeds our motivation to conduct clinical and basic scientific research in order to serve our patients in the best possible way.
Facial nerve paralysis
In facial paralysis, one of the facial nerves does not function. This often results in an asymmetrical face, impaired facial expression, or eye problems, since the eye cannot be closed anymore. Furthermore, patients are often not able to laugh, or can only produce an asymmetrical laugh, that can lead to social and psychological problems. Acquired facial paralysis due to infections, is often temporary and recovers spontaneously. If it does not recover, or the paralysis is congenital, there are several treatment options, such as botox injections and mime therapy. There are also many surgical treatments that can be used to restore function and facial expression. However, full recovery of facial expressions is often not possible.
Professor and plastic surgeon Paul Werker is specialized in the treatment of this condition. At this moment, he supervises a research project on the functional outcome after a surgical facial nerve reconstruction.
Facial paralysis results in muscle atrophy on the long term. Therefore, surgical treatments not only include nerve transplantations, but also muscle transplantations. Although such surgical procedures result in a more symmetrical face and improved function, regeneration of the atrophied muscles is not possible. PhD graduate Merel Koning investigated the possibility to build skeletal muscle using tissue engineering. This project provides fundamental knowledge ant tools towards the regeneration of the facial muscles, or other skeletal muscles.
The PhD thesis of Merel Koning can be downloaded from this link
Oral and maxillofacial reconstructions
In some cases of mouth and neck cancer, there is no other solution than (partial) resection of the upper or lower jaw. These procedures are very mutilating, and result in severe functional and psychosocial problems. In such cases, plastic surgeons might be able to reconstruct the face, for example by transplanting parts of the fibula to form a new jaw. This commonly used technique is called the free fibular flap.
PhD candidate Sophie Post coordinates research on the quality of life after transplantation of a free fibular flap. Her project also covers aspects of chew function, speech, and complications.
Schisis is a congenital cleft in the lip, jaw and/or palate. Due to the cleft, newborns often have problems with feeding, since they are not able to suck. So, infants with schisis get in contact with our multidisciplinary team shortly after birth. Usually, the infants are treated surgically in the first few months of life. The Department of Plastic Surgery is involved in large international study that is aimed to develop a validated questionnaire to measure quality of life in children with schisis, aged from 5-18 years old.