Ali Sherif, Abdel Aziz Omniya, Ahmed Mamdouh
Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
Oral and Maxillofacial Surgery Department, Nasser Institute for Treatment and Research, Cairo, Egypt.
Maxillofac Plast Reconstr Surg. 2022 May 7;44(1):20. doi: 10.1186/s40902-022-00348-4.
Temporal hollowing is a common complication following the rotation of the temporalis muscle that leaves the patient with a cosmetic impairment. Several alloplastic materials have been used to reconstruct the donor site; however, these implants need meticulous adaptation to conform the periphery of the defect and restore the contour of the temporal area. The aim of this study was to assess the use of patient-specific polyetheretherketone (PEEK) temporal implants to prevent temporal hollowing following the use of full temporalis muscle flap for large maxillary defects reconstruction.
This was a prospective study conducted on eight patients with major maxillary defects indicating the need of reconstruction with full temporalis muscle flap or any lesion indicating major maxillary resection and immediate reconstruction with total temporalis muscle flap. For each patient, a patient-specific PEEK implant was fabricated using virtual planning and milled from PEEK blocks. In the surgical theater, the temporalis muscle was exposed, elevated, and transferred to the maxilla. After the temporalis muscle transfer, PEEK implants were fixed in place to prevent temporal hollowing.
The surgical procedures were uneventful for all patients. The esthetic result was satisfactory with no post-operative complications except in one patient where seroma occurred after 2 weeks and resolved after serial aspiration.
Patient-specific PEEK implant appears to facilitate the surgical procedures eliminate several meticulous steps that are mainly based on the surgeon's experience.
Clinical trials registration: NCT05240963 .
颞部凹陷是颞肌旋转术后常见的并发症，会给患者带来容貌损害。已有多种异体材料用于修复供区；然而，这些植入物需要精细调整以贴合缺损边缘并恢复颞部轮廓。本研究的目的是评估使用定制聚醚醚酮（PEEK）颞部植入物预防在使用全颞肌瓣修复大型上颌骨缺损后出现颞部凹陷的效果。
这是一项针对8例上颌骨重大缺损患者的前瞻性研究，这些患者需要用全颞肌瓣进行修复，或因任何病变需要进行上颌骨大部切除并立即用全颞肌瓣进行重建。对于每位患者，使用虚拟规划制作定制的PEEK植入物，并从PEEK块材中铣削而成。在手术台上，暴露、掀起颞肌并转移至上颌骨。在颞肌转移后，固定PEEK植入物以防止颞部凹陷。
所有患者手术过程均顺利。除1例患者术后2周出现血清肿，经多次抽吸后消退外，美学效果满意，无术后并发症。
定制的PEEK植入物似乎有助于简化手术过程，省去了一些主要基于外科医生经验的精细步骤。
临床试验注册：NCT05240963 。
