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Titanium mesh in the reconstruction of a malar defect: a case report
António Fernandes Massa1, Mercedes Otero-Rivas, Manuel Ángel Rodríguez-Prieto
1Department of Dermatology, Centro Hospitalar de Vila Nova de Gaia/Espinho (Vila Nova de Gaia and Espinho Hospital Center), Vila Nova de Gaia, Portugal; Department of Dermatology, Complejo Asistencial Universitario de León (Care Complex of the University of León), León, Spain.
Background:
Increasing rates of non-melanoma skin cancer support the use of prosthetic materials for the closure of post-surgical defects with cartilage or bone involvement. The use of allografts, especially titanium, is well established in maxillofacial procedures but is uncommon in dermatologic surgery.
Methods:
A 92-year-old man presented with a basal cell carcinoma measuring 2×3 cm on the right cheek. Computed tomography showed infiltration of the anterior maxillary sinus wall. The tumor was excised under general anesthesia. The final defect comprised skin, muscle, the central portion of the maxillary bone and part of the maxillary sinus mucous. The defect was closed with titanium mesh and covered with a rotation flap from the right cheek. The secondary defect created by the preauricular rotation was closed with a free skin graft from the supraclavicular area.
Results:
The use of titanium mesh enabled satisfactory esthetic and functional results to be achieved safely and quickly.
Conclusions:
Titanium mesh facilitates the repair of large defects and avoids the second intervention and increased risk for infection associated with bone grafting. Reconstruction with titanium mesh is considered a valuable technique in post-trauma fractures and post-oncologic defects but remains underused in dermatologic surgery. The present experience supports its use as a reliable option in bone replacement.
