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[Long-term results following reconstruction of maxillary sinus wall defects with titanium micro-mesh: a CT-based
J J Kuttenberger1, N Hardt, T C Treumann
1Klinik für Mund-, Kiefer- und Gesichtschirurgie, Kantonsspital Luzern. johannes.kuttenberger@ksl.ch
Background:
Extensive bony defects of maxillary sinus walls have to be reconstructed to prevent long-term complications. Different autogenous, allogeneic, and alloplastic materials, e.g., titanium mesh, are used for reconstruction.
Material And Methods:
In 26 patients large defects of the facial and laterodorsal walls of the maxillary sinus were reconstructed using titanium micro-mesh. The mean follow-up period was 49 months (5 months-10 years). All patients were examined with computed tomography applying multiplanar reconstruction techniques and three-dimensional volume rendering.
Results:
In the CT scans stable scars of 3-6 mm thickness could be found on the antral surfaces of all titanium meshes bridging the defects. In 70% of the patients the volume of the reconstructed maxillary sinus reached 80-100% of the contralateral side. Volume losses were not due to poor adaptation of the titanium mesh but were caused by thickening of maxillary sinus walls or traumatic malpositions. In 77% of the patients ventilation of the maxillary sinus was undisturbed. After mesh removal neither facial contour disturbances nor changes of sinus volume were noted. Soft tissue invasion into the sinus was prevented by a stable scar which had formed underneath the mesh. Three-dimensional reconstruction confirmed symmetrical facial contours in all patients.
Conclusions:
The titanium micro-mesh offers a simple and effective alternative to autogenous tissue with stable long-term results for reconstruction of large maxillary sinus wall defects.