Roger Ebert 'At the Movies' Again With Silicone Chin

Roger Ebert returns as movie critic with silicone chin and electronic voice.

ByKIM CAROLLO<br>ABC News Medical Unit
January 24, 2011, 3:35 PM

Jan. 25, 2011&#151; -- 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."

Ebert Suffered From Thyroid Cancer and Salivary Gland Cancer

"You can also run into problems such as infection or extrusion, which happens when the silicone comes out through the skin," said Dr. Liza C. Wu, assistant professor in the Division of Plastic Surgery at the University of Pennsylvania.

Problems can arise from using the body's own tissue as well.

"This kind of reconstruction can be more complicated, and the biggest problem is failure," said Wu.

"There could be a problem with circulation into the flap, which is the tissue moved from one part of the body to the other," said Garfein. "When you plug the blood vessels from the other tissue into the neck, there could be a problem with the artery that brings blood in and out of the flap."

Cancer specialists say it's extremely rare for thyroid cancer to cause complications as serious as losing the voice or requiring reconstructive surgery.

"That's extreme to the point of being almost unheard of," said Dr. Robert Udelsman, chair of the Department of Surgery at the Yale University School of Medicine in New Haven, Conn. "It's possible to spread, but that's more than a little unusual."

Udelsman said the majority of people with thyroid cancer are cured. The most common type of thyroid cancer is papillary thyroid cancer, the type Ebert had.

"The papillary form probably accounts for about 75 percent of all thyroid cancers, and the vast majority are cured," he said.

Treatment often involves surgically removing the entire thyroid. Surgery can be tricky, Udelsman said, and occasionally the vocal cord nerves can be damaged.

Ebert had surgery to remove cancer from his salivary gland in 2003, but as he said in his journal, his surgery didn't go well.

"What happened was, cancer of the salivary gland spread to my right lower jaw. A segment of the mandible was removed. Two operations to replace the missing segment were unsuccessful, both leading to unanticipated bleeding," Ebert wrote.

According to the National Cancer Institute, cancer of the salivary gland is rare and treatment can include surgery, depending on the stage and aggressiveness of the cancer.

Ebert says he has no problem showing off his new look.

"I accept the way I look. Lord knows I paid the dues," he wrote.

ABC News' Lauren Cox and Ki Mae Heussner contributed to this report.

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