Delicate and risky surgery removes cancer without harming facial nerves
MAYWOOD, Ill. – To look at Henry Fiorentini’s artificial right ear, you could never tell he lost his real ear to cancer.
Loyola University Medical Center ear surgeon Sam Marzo, MD, fitted Fiorentini with a prosthetic ear that looks just like the real thing. Marzo implanted three small metal posts in the side of Fiorentini’s head. Each post is fitted with a magnet. The silicone prosthetic ear also is magnetized, so it sticks to the metal posts.
But even more remarkable to Fiorentini is the delicate surgery Marzo performed to successfully remove the cancer, without harming the facial nerve. Other doctors had told Fiorentini it couldn’t be done.
“Dr. Marzo saved my life,” said Fiorentini, 56. “I now have a long life ahead of me, free of significant disfiguration and recurrent cancer."
Fiorentini had basal cell skin cancer, the most common type of cancer in the United States. It’s slow-growing and usually easily treated. But in Fiorentini’s case, the cancer would become life-threatening.
The cancer started behind his right ear. And despite multiple surgeries at other centers, the cancer persisted. By the time Fiorentini came to Marzo, his right ear was gone. He had lost hearing on one side, and the area was a mass of scar tissue and relocated nerves.
The scar tissue would greatly complicate any subsequent surgery. Marzo would have to find and trace the facial nerves, which had all but disappeared into the scar tissue zone and then work around them. If Marzo inadvertently cut a facial nerve, Fiorentini could be paralyzed on one side of his face. But in order to remove the cancer once and for all, Fiorentini and Marzo were willing to take the risk.
The surgery, which lasted nearly all day, was successful. Marzo was able to remove all the cancer, without harming the facial nerve. Fiorentini has been cancer-free for more than five years.
Marzo referred Fiorentini to a facial prosthetist, who fashioned a prosthetic ear made of silicone. The flesh-colored prosthesis did not restore Fiorentini’s hearing, but it did wonders for his appearance. The silicone ear looks remarkably real, right down to the small blood vessels. Fiorentini removes it when he goes to bed, and puts it back on after his morning shower.
“It is virtually indistinguishable from my other ear,” he said.
Marzo is medical director of Loyola’s Balance and Hearing Center and a professor in the departments of Otolaryngology and Neurological Surgery at Loyola University Chicago Stritch School of Medicine.