[Osteointegrated cranio-facial implants: 49 patients report]

To analyze the results obtained in the total implanted population in Strasbourg, in order to assess the reliability of this technique over the long-term, especially in children and in irradiated patients.

This is a retrospective study including all the cases of cranio-facial epitheses implanted in the department of Otorhinolaryngology, head and neck surgery at the University Hospital of Strasbourg since 1992, date of the first epithesis implantation. The results (rate of osseo-integration, cutaneous complications, degree of satisfaction) are presented according to the site of implantation and the antecedent of irradiation. The results obtained in children (16 years of age and less) are specified.

The study involved 50 patients (including 11 children), that is 51 epitheses, auricular, orbito-palpebral or naso-maxillary. 142 implants were fixed, including 49 in irradiated patients. The average rate of osseo-integration was 95.7% in the absence of irradiation, and 81.6% following irradiation, with significant differences according to the site of the implant (worse in the nasal site). Radiotherapy being a factor which reduces the rate of osseo-integration. The success rate in children was comparable to the one obtained in adults.

The extraoral osseous implantology has made it possible for the facial epitheses to be considered as a forerunner in the strategies of rehabilitation in facial loss of substance, with the surgical rehabilitation techniques. It is particularly interesting in oncology, as it allows easy clinical monitoring of the operation site.