[Use of extraoral implants for nasal rehabilitation with epithesis after carcinologic surgery. A case report]

Maxillofacial defect caused by cancer treatment represents a problem affecting the quality of life of patients. Epithethic solutions are indicated if plastic surgery reconstruction is not a valid option for an extensive defect. We present the case of a 42 years-old woman, who had undergone a total nasal resection, for a well-differentiated epidermoid carcinoma of the tip of the nose. The anatomopathologic analysis of the piece of resection showed free margins, and did not reveal any ganglionar metastasis. No radiotherapy was applied. Three months later, four extraoral implants were placed in the frontal and paranasal areas with a transcutaneous approach, in order to avoid crusting resulting from trans-nasal mucosa emergence of the fixtures. After four months, each implant as a bone anchorage was connected with a prosthetic retention device to be connected to the nasal epithese. After four weeks, cutaneous healing allowed the prosthetic steps to be achieved. The use of extraoral fixtures as bone anchorage for a nasal epithesis represents an alternative to more heavy and time-consuming surgical reconstruction techniques. Another advantage is that the site can be monitored easily because the epithesis is removable, as for the carcinologic follow-up. It allows a good retention of the nasal epithesis and an esthetic result which is satisfying for the patient.