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Custom Endoprosthesis-Assisted Pediatric Microsurgical Jaw Reconstruction
Collean Trotter1,2, Devon O'Brien1,2, Eloise W Stanton1,2
1Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles.
The Journal of Craniofacial Surgery
|July 2, 2024
Summary
Custom endoprostheses (CE) show improved outcomes in pediatric mandibular reconstruction, reducing complications and revisions compared to noncustom reconstruction (NCR). CE also enabled reconstruction of larger maxillary defects with similar complication rates.
Area of Science:
- Oral and Maxillofacial Surgery
- Pediatric Oncology
- Biomedical Engineering
Background:
- Pediatric tumors of the jaw can lead to significant disfigurement and functional deficits.
- Reconstruction presents challenges in restoring form and function without hindering growth.
Purpose of the Study:
- To compare the outcomes of custom endoprosthesis (CE) versus noncustom reconstruction (NCR) for pediatric maxillary and mandibular tumors.
- To introduce an algorithm for optimizing reconstructive options using CE.
Main Methods:
- Retrospective review of 51 patients (2016-2022) undergoing maxillary or mandibular reconstruction.
- Analysis of CE utilization, hardware failure, major complications, and revision surgeries.
- Statistical analysis including t-tests, chi-squared tests, and logistic regression.
Main Results:
- CE significantly reduced hardware exposure, failure, major complications, and revisions in mandibular reconstruction compared to NCR.
- Maxillary reconstruction with CE did not show significant differences in complications but reconstructed larger defects.
- The proposed algorithm improved mandibular reconstruction outcomes without increasing maxillary complications.
Conclusions:
- Custom endoprostheses are a safe and effective option for pediatric jaw reconstruction.
- CE may facilitate improved form and function in pediatric patients.
- An algorithm can guide CE use for optimizing reconstructive outcomes.
