MAYWOOD, IL (July 7, 2020) – When 62-year-old Bartlett resident Norvell Bujarski was diagnosed with cancer, it was advanced. When he learned that he had squamous cell cancer of the nasal cavity, he didn’t want to settle for noninvasive approaches that may only offer him a partial extension of his life. He wanted to live a full life and was seeking a cure. In order to remove all of his tumors, Mr. Bujarski’s cancer surgeon would have to remove his entire nose including bone and tissue, eight of his front teeth and part of the roof of his mouth. When he needed a maxillofacial prosthesis to restore his form and function, he went to Dr. Charles Palin at Loyola University Medical Center's Oral Health Center.
Charles Palin, DMD is a specialist in maxillofacial prosthodontics at Loyola Medicine who cares for patients with head and neck cancers, trauma, congenital defects and anomalies. This subspecialty of prosthodontics involves rehabilitation of patients, often including prostheses to replace missing areas of bone or tissue and restore oral functions such as swallowing, speech and chewing. Only 16.5% of prosthodontists complete an ADA-accredited program in maxillofacial prosthetics like Dr. Palin did at Memorial Sloan-Kettering Cancer Center in New York in 2017. Dr. Palin has a unique perspective as a cancer survivor who is ten years cancer-free after being diagnosed with acute lymphoblastic leukemia in 2009.
Mr. Bujarski first came to Dr. Palin in 2018 to address the altered state of his face, nose, teeth and mouth. Without his front teeth and the roof of his mouth, he had difficulty eating, drinking and speaking. Without a nose, he didn’t want to look in the mirror or leave the house. “I had my moments where I had pity and sympathy for myself. But not very often because I felt blessed to be here,” he said. Mr. Bujarski and his wife consulted with the team at Loyola Medicine about their options. Facial reconstruction was an option that would require 10-15 more surgeries over several years as well as significant recovery. “That didn’t make sense to me,” he decided.
With the goal of restoring Mr. Bujarski’s oral cavity, teeth and nose, the plan included creating a set of customized prostheses including dentures and an obturator, which fills in the missing bone and tissue in the roof of the patient’s mouth, allowing him to eat, drink and breathe more normally. “Without the roof of the mouth, the patient can experience food and drink escaping into the nasal cavity, which is unpleasant and makes eating in public problematic,” says Dr. Palin.
Following surgery, Mr. Bujarski had been wearing a flat white bandage to cover the opening where his nose once was. While waiting for the creation of a more permanent prosthesis, a 3-D printer was used to create a temporary prosthetic nose for Mr. Bujarski which he secured to his face with medical tape. In late 2019, he received a prosthetic nose that secures with a magnet, attaching to the obturator in the roof of his mouth. Both the temporary and permanent prosthesis were created by Medical Art Prosthetics.
“How awkward is that not to have a nose?” said Mr. Bujarski, “with my new prosthetic, 99.9% of people aren’t able to tell that I don’t have a nose. I don’t have to use tape or glue, the magnet works perfectly.” Dr. Palin places priority on returning patients to their daily lives. “The face is personal, it’s your own. You want to look like yourself and return to your everyday life.” says Dr. Palin.