Complex craniofacial reconstruction with prostheses as an alternative method to autogenous reconstruction

Area of Science:

• Plastic Surgery
• Oromaxillofacial Surgery
• Biomaterials Engineering

Background:

• Autogenous tissue reconstruction is standard for facial defects but not always suitable.
• Epitheses provide an alternative for complex reconstructions or when patients cannot undergo surgery.
• Osseointegrated implants enhance the stability and retention of facial prostheses.

Purpose of the Study:

• To evaluate factors influencing the success of facial reconstructions using externally retained prostheses.
• To assess the impact of defect location and radiotherapy on implant-assisted epithesis outcomes.
• To determine the viability of osseointegrated implants for facial defect rehabilitation.

Main Methods:

• Retrospective evaluation of 10 patients with facial tissue defects treated with osseointegrated implants.
• Analysis of 44 implants across ear, nasal, and midfacial regions over an average of 52.4 months.
• Correlation of implant success/loss with defect location and radiotherapy history.

Main Results:

• Overall implant loss rate was 31.8% (14/44 implants).
• Higher implant loss occurred in the midfacial region (27.2%) and glabellar region (4.5%).
• No implant losses or infections were noted in the mastoid region for ear reconstructions.

Conclusions:

• Implant-assisted epitheses are a successful alternative for facial reconstruction when autogenous tissue is not an option.
• Defect location significantly impacts implant survival rates, with midfacial defects showing higher loss.
• Osseointegrated implants provide a stable foundation for facial prostheses, improving patient quality of life.