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植入式鼻腔修复假体在大鼻部分切除术缺损重建中的应用:索尔兹伯里经验。

Implant-retained nasal prosthesis for reconstruction of large rhinectomy defects: the Salisbury experience.

机构信息

Department of Oral & Maxillofacial Surgery, Odstock Centre for Burns, Plastic and Maxillofacial Surgery, Salisbury District Hospital, Salisbury SP2 8PJ, United Kingdom.

出版信息

Int J Oral Maxillofac Surg. 2010 Apr;39(4):343-9. doi: 10.1016/j.ijom.2010.01.003. Epub 2010 Feb 9.

Abstract

The authors report their experience with 34 patients who had large full thickness nasal defects reconstructed with an implant-retained prosthesis. Their technique of modifying post-rhinectomy defects is described and factors influencing implant success are evaluated. 111 implants were placed to retain a nasal prosthesis. Age, sex and tumour histology did not affect the outcome. Smoking, extent of rhinectomy, use of radiotherapy (pre- and post-implant), hyperbaric oxygen, length and location of the implant and type of retention (bar/magnets) influenced implant success. The overall success rate was 89% (99/111); 94% in patients who did not receive radiotherapy and 86% in those who did. The prosthesis was in place in all patients (100%) at the time of last follow up. Post-rhinectomy defect modification enables adequate access for safe placement of long implants with good primary stability and helps the maintenance of good hygiene (further enhanced by the use of skin grafts). The authors think implant-retained prosthesis is a reliable option for reconstructing large full thickness rhinectomy defects. They suggest their technique of modifying the defect, use of long implants and magnets for retention is responsible for the high success rate of implants used to retain a nasal prosthesis.

摘要

作者报告了他们用植入物保留的假体重建 34 例全厚鼻缺损患者的经验。描述了他们修复鼻后切除术缺损的技术,并评估了影响植入物成功的因素。为保留鼻假体共放置了 111 个植入物。年龄、性别和肿瘤组织学不影响结果。吸烟、鼻切除术的范围、放疗的应用(植入前和植入后)、高压氧、植入物的长度和位置以及保留方式(棒/磁铁)影响植入物的成功。总体成功率为 89%(99/111);未接受放疗的患者成功率为 94%,接受放疗的患者成功率为 86%。在最后一次随访时,所有患者(100%)的假体都在位。鼻后切除术缺损的修复为安全放置具有良好初始稳定性的长植入物提供了足够的通道,并有助于保持良好的卫生(通过使用皮肤移植物进一步增强)。作者认为,植入物保留的假体是重建全厚鼻切除术缺损的可靠选择。他们认为,他们修复缺损的技术、使用长植入物和磁铁保留假体,是植入物用于保留鼻假体高成功率的原因。

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