[Prosthetic management of tumor-induced nasal defects]

Reconstructive plastic surgery is not always possible or advisable for nasal defects following tumor resections. Facial prostheses offer an alternative therapy. Since 1991, 37 patients with nasal defects after tumor surgery were treated in the Berlin Center of Facial Prostheses: 28 received "soft" silicone facial prostheses and 9 "solid" polymethylmetacrylate facial prostheses. In 35 patients protheses were bone-anchored: Brånemark implants were used in 12 patients and an Epitec frame construction in 23 patients. Glue-on prostheses were applied to only two patients. No intraoperative complications occurred at implant insertion. During following visits only minor inflammations were observed around implants and were treated locally. The implant success rate was 78% for the Brånemark implants (89.7% in non-radiated areas and 50% in radiated areas) and 100% in radiated and non-radiated areas for the Epitec system. Our investigation shows that given the right indication, the bone-anchored facial prosthesis is safe, cosmetically acceptable, uncomplicated and not stressful for the patient.