They used cadaver bones as a form of scaffolding, then implanted stem cells created with the patient’s own body fat, allowing Brad Guilkey to overcome Treacher Collins syndrome, a genetic condition resulting in underdeveloped or non-existent cheek bones.
Key to success was the addition to the bone-stem cell graft of an engineered form of a protein called bone morphogenic protein-2 (BMP-2), which stimulates bone growth. BMP-2 cued the stem cells to form bone tissue.
Before trying the procedure the scientists did a complete study using pigs, which was published in March.
An interdisciplinary team developed the procedure, combining plastic surgeons with experts on tissue development within the hospital. The hospital was also able to do a complete PR work-up on its Web site, including a press release, backgrounders, and multiple explanations of the science involved.
Past attempts to regrow bone had floundered, disfiguring the patients even when their own bones were used. The Cincinnati procedure took a full day, and the family gave permission to go public with the full story in order to help others.
In the Guilkey case an additional plastic surgery will be needed to adjust the downward slant of the eyelids, which is another characteristic of Treacher-Collins syndrome. Guilkey is now 15, the hospital said.
The release was issued over four months after the surgery, which was performed May 28, and the hospital’s PR package includes before-and-after pictures of the patient. (Your moment of snark. They also cut the kid’s hair.) Local TV reporters got some shots of the teen in which he is much better looking. (Four months of healing will do that.)
Without a cheekbone, normal activities are nearly impossible. If you get hit with a dodgeball in gym class, for instance, it can crush your eyeball.