The Associated Press
LONDON - A German who had his lower jaw cut out because of cancer has enjoyed his first meal in nine years - a bratwurst sandwich - after surgeons grew a new jawbone in his back muscle and transplanted it to his mouth in what experts call an "ambitious" experiment.
According to this week's issue of The Lancet medical journal, the German doctors used a mesh cage, a growth chemical and the patient's own bone marrow, containing stem cells, to create a new jawbone that fit exactly into the gap left by the cancer surgery.
Tests have not been done yet to verify whether the bone was created by the blank-slate stem cells and it is too early to tell whether the jaw will function normally in the long term. But the operation is the first published report of a whole bone being engineered and incubated inside a patient's body and transplanted.
Stem cells are the master cells of the body that go on to become every tissue in the body. They are a hot area of research with scientists trying to find ways to prompt them to make desired tissues, and perhaps organs.
But while researchers debate whether the technique resulted in a scientific advance involving stem cells, the operation has achieved its purpose and changed a life, said Stan Gronthos, a stem cell expert a the Institute of Medical and Veterinary Science in Adelaide, Australia.
"A patient who had previously lost his mandible (lower jaw) through the result of a destructive tumor can now sit down and chew his first solid meals in nine years...resulting in an improved quality of life," said Gronthos, who was not connected with the experiment.
The operation was done by Dr. Patrick Warnke, a reconstructive facial surgeon at the University of Kiel in Germany. The patient, a 56-year-old man, had his lower jaw and half his tongue cut out almost a decade ago after getting mouth cancer. Since then, he had only been able to slurp soft food or soup from a spoon.
In similar cases, doctors can sometimes replace a lost jawbone by cutting out a piece of bone from the lower leg or from the hip and chiseling it to fit into the mouth.
This patient could not have that procedure because he was taking a potent blood thinner for another condition and doctors considered it too dangerous to harvest bone from elsewhere in his body since extraction leaves a hole where the bone is taken, creating an extra risk of bleeding.
Artificial jaws made from plastic or other materials are not used because they pose too much of a risk of infection.
"He demanded reconstruction," Warnke said. "This patient was really sick of living."
Warnke and his group began by creating a virtual jaw on a computer, after making a three-dimensional scan of the patient's mouth.
The information was used to create a thin titanium micro-mesh cage. Several cow-derived pure bone mineral blocks the size of sugar lumps were then put inside the structure, along with a human growth factor that bulds bone and a large squirt of blood extracted from the man's bone marrow, which contains stem cells.
The surgeons then implanted the mesh cage and its contents into the muscle below the patient's right shoulder blade. He was given no drugs, other than routine antibiotics to prevent infection from the surgery.
The implant was left in for seven weeks, when scans showed new bone formation. It was removed about eight weeks ago, along with some surrounding muscle and blood vessels, put in the man's mouth and connected to the blood vessels in his neck.
Scans showed new bone continued to forum after the transplant.
I think that this shows that Stem Cell research can truly be beneficial, and not against human nature. Now perhaps total cloning of people would be out of the question, but in cases such as these, it can truly make a difference.
A man can actually eat after nine years of losing his jaw. How many people out there have lost a part of their body, that we all take for granted. Perhaps with further research, such things can be made possible.
Is it right to prevent such research?