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Medical prosthetic applications of growth simulations in four-dimensional facial morphology

Growth data on the developing human face has been collected by scientists in a number ofdifferent disciplines for nearly one hundred years. Most of the work in this area has been the result of attempts to understand and quantify the growth process or in attempting to establish population norms or baseline standards for use in syndromology. Anthropologists geneticists ophthalmologists orthodontists otorhinolaryngologists pediatric syndromologists plastic surgeons radiologists have all contributed to the literature on facial development1. While this literature for facial assessment is very complete but its use and value in prediction has not been exploited to-date. The preliminary work presented in this paper uses the available literature to predict growth and development ofthe nose. These predictions were used in fabricating a series ofnasal prostheses that will be used to establish facial cosmesis during the growth years. This case involves a six year old male who had undergone a total rhinectomy and septectomy required a nose prosthesis to cover a severe facial defect and to effect cosmesis. Based on laser scan data from casts ofthe patient''s pre-surgical nose a selected series ofanthropometric landmarks were identified and scaled. Growth algorithms provided new positions for control points that simulated growth of the nose over time. The resulting series of geometric models were initially fabricated using stereolithography and later modeled in a medical grade silastic. Growth predictions used to simulate the morphological remodelling of facia