Renowned movie critic Roger Ebert returned to the small screen to talk about the big screen over the weekend in the new show "Roger Ebert Presents At the Movies" looking much different than he did the last time he gave one of his famous "thumbs up/thumbs down" ratings several years ago.
Ebert, who lost the lower part of his jaw and his voice box after complications from thyroid and salivary gland cancer, appeared in a segment at the end of the show with his new prosthetic chin and an artificial voice in place of what he lost.
"I will wear the prosthesis on the new television show. That's not to fool anyone, because my appearance is widely known. It will be used in a medium shot of me working in my office, and will be a pleasant reminder of the person I was for 64 years," Ebert wrote in his blog published by the Chicago Sun-Times. "When people see the 'Roger's Office' segment, they'll notice my voice more than my appearance," he continued.
A Scotland-based company, CereProc, reconstructed Ebert's voice using archived footage of him from his show "At the Movies." The company says there are realistic animated and emotional aspects to the voices it creates with its software.
Ebert's chin is a silicone prosthesis that is similar to dentures in that it's not meant to be worn all the time.
Dr. David Reisberg, a maxillofacial prosthodontist at the University of Illinois Medical Center in Chicago, helped create Ebert's prosthetic chin.
"We wanted to design a prosthesis that would elevate his lower jaw or chin area," said Reisberg. "It wasn't so much because he wanted to look better, but he felt that other people would be more comfortable dealing with him."
The prosthesis rests on Ebert's shoulder blades and is almost like a collar, Reisberg said. Since he doesn't wear the chin every day, it's unlikely there will be any complications, which would be minor.
"The material itself doesn't last forever," said Reisberg. "Skin oils can cause some breakdown and it tends to turn yellow."
Reisberg also said that reconstructive surgery is generally the best option, but Ebert suffered from complications from previous procedures. Reisberg couldn't elaborate on those problems because he wasn't involved in that part of Ebert's cancer treatment.
Surgeons say silicone implants and silicone prostheses are two options for facial reconstruction. Depending on the severity of the facial trauma or personal preference, patients may also opt to use their own tissue.
"One way to reconstruct the jaw is with bone from fibula [calf bone]," said Dr. Evan Garfein, assistant professor of surgery at Montefiore Medical Center in the Bronx, N.Y. "You can cut pieces to form the shape of a jaw and can use some skin and connective tissue from outside of the leg to reconstruct the floor of the mouth or the chin."
Garfein said using the body's own tissue is preferable to using silicone because of potential complications. "If an area's had radiation, you don't want to put a foreign body into it. It's already a 'hostile environment' because of the radiation, and then adding saliva, muscular forces, food and other things can create complications."