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使用锁定聚醚醚酮(PEEK)定制面部植入物治疗面部畸形:十例患者的回顾性研究

The Use of Interlocking Polyetheretherketone (PEEK) Patient-Specific Facial Implants in the Treatment of Facial Deformities. A Retrospective Review of Ten Patients.

作者信息

Anabtawi Mohammed, Thomas Mathew, Lee Nicholas J

机构信息

Specialist Registrar, Department of Oral and Maxillofacial Surgery, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

Consultant Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK.

出版信息

J Oral Maxillofac Surg. 2021 May;79(5):1145.e1-1145.e9. doi: 10.1016/j.joms.2020.12.009. Epub 2020 Dec 18.

Abstract

PURPOSE

Polyetheretherketone (PEEK) is a versatile biocompatible material with a wide variety of clinical applications. Multiple-piece 3-dimensionally milled interlocking PEEK patient-specific implants are used in cases with restricted access or around vital structures. The interlocking joints reduce the number of fixation screws required by converting the multiple segments into 1 single implant. Stability of such joints is of paramount importance to prevent complications such as infection and implant extrusion. This retrospective study evaluates the clinical outcomes in the use of multiple-piece 3-dimensionally milled interlocking PEEK patient-specific implants as a treatment for various congenital and acquired facial deformities.

METHODS

Patients' records and clinical interviews were retrospectively reviewed.

RESULTS

A total of 10 patients were included; 6 of them (60%) were men. A planning cone beam scan (90%) or computed tomography scan (10%) were obtained following a standard protocol. All treatments were performed by a single surgeon, following a standardized approach. The follow-up time ranged from 11 to 61 months (mean = 37.1 months). No implant exposure, extrusion or removal were reported. Three patients (30%) experienced complications. Recurrent edema was observed in 1 patient (10%), another patient (10%) experienced bilateral mental nerve paresthesia, and the third patient (10%) had recurrent sinusitis, which was successfully treated with functional endoscopic sinus surgery without removing the implant.

CONCLUSION

Within the limitation of this study, 3-dimensionally milled interlocking PEEK patient-specific implants are safe, predictable, potentially save operative time, and readily adjustable. Extra stability and antislippage mechanism can be achieved by using the interlocking joint. Further studies on a larger cohort of patients is needed to confirm these results.

摘要

目的

聚醚醚酮(PEEK)是一种用途广泛的生物相容性材料,具有多种临床应用。多块三维铣削互锁式PEEK定制植入物用于手术入路受限或重要结构周围的病例。互锁关节通过将多个节段转换为单个植入物,减少了所需固定螺钉的数量。此类关节的稳定性对于预防感染和植入物挤出等并发症至关重要。本回顾性研究评估了使用多块三维铣削互锁式PEEK定制植入物治疗各种先天性和后天性面部畸形的临床结果。

方法

对患者记录和临床访谈进行回顾性分析。

结果

共纳入10例患者;其中6例(60%)为男性。按照标准方案进行了计划锥形束扫描(90%)或计算机断层扫描(10%)。所有治疗均由一名外科医生采用标准化方法进行。随访时间为11至61个月(平均37.1个月)。未报告植入物暴露、挤出或取出情况。3例患者(30%)出现并发症。1例患者(10%)出现反复水肿,另1例患者(10%)出现双侧颏神经感觉异常,第3例患者(10%)患有复发性鼻窦炎,经功能性鼻内镜鼻窦手术成功治疗,未取出植入物。

结论

在本研究的局限性内,三维铣削互锁式PEEK定制植入物安全、可预测,可能节省手术时间且易于调整。使用互锁关节可实现额外的稳定性和防滑机制。需要对更大规模的患者队列进行进一步研究以证实这些结果。

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