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一种通过使用定制颧骨植入物修复毛霉菌病后上颌骨切除术缺损的新方法。

A Novel Method to Rehabilitate Post-mucormycosis Maxillectomy Defect by Using Patient-Specific Zygoma Implant.

作者信息

Patel Nehal, Mel Anshul, Patel Pooja, Fakkhruddin Ansari, Gupta Saloni

机构信息

M.D.S- Oral and Maxillofacial Surgery, Nuface Maxillofacial and Dental Hospital, Plot No.2, Sai Nagar, Anand Mahal to Adajan Gam Road, Adajan, Surat, Gujarat 395009 India.

M.D.S. - Oral and Maxillofacial Prosthodontics, Nuface Maxillofacial and Dental Hospital, Plot No.2, Sai Nagar, Anand Mahal to Adajan Gam Road, Adajan, Surat, Gujarat 395009 India.

出版信息

J Maxillofac Oral Surg. 2023 Mar;22(Suppl 1):118-123. doi: 10.1007/s12663-023-01847-1. Epub 2023 Feb 3.

Abstract

AIM

During second wave of COVID pandemic, India faced heavy surge of mucormycosis. Treatment option for these patients included either total or partial maxillectomy with primary closure. Rehabilitation of these patients became challenging because of their age and size of defect. The purpose of the present study is to present a new digital technique for the fabrication of patient-specific zygoma implants (PSI) and to report on its survival and complication rates.

MATERIAL AND METHODS

Total 21 patients who had undergone either partial or total maxillectomy after mucormycosis and who were disease-free clinically and radiographically for 6 or more months post-resection were rehabilitated using patient-specific zygoma implant. CT scan was obtained for all patients post-maxillectomy for evaluation of existing bone condition. Exocad software was used for virtual surgical planning of zygoma implant considering surgical and prosthetic technicality to achieve goal of maximum functionality and sustainability.

RESULT

All the patients were followed up after 15, 30, 45 and 90 days and there after every month for evaluation of soft tissue healing, infection, dehiscence, loosening of prosthesis, eating efficiency and aesthetic. Follow-up period for all 15 patients was in the range of 6-12 months.

CONCLUSION

In case of post-mucor maxillectomy patients, use of PSI offers the advantages of minimal bone augmentation, reduction in time required to restore lost function, and reduced financial burden of multiple procedures. Therefore, PSI may represent a valid alternative treatment for the prosthetic restoration of post-mucor maxillectomy patients.

摘要

目的

在新冠疫情第二波期间,印度毛霉菌病患者数量大幅激增。这些患者的治疗选择包括全上颌骨切除术或部分上颌骨切除术并一期缝合。由于患者年龄和缺损大小,这些患者的康复变得具有挑战性。本研究的目的是介绍一种用于制造定制颧骨种植体(PSI)的新数字技术,并报告其生存率和并发症发生率。

材料与方法

共有21例毛霉菌病后接受部分或全上颌骨切除术的患者,在切除术后临床和影像学上无疾病6个月或更长时间,使用定制颧骨种植体进行康复治疗。所有患者在全上颌骨切除术后均进行CT扫描,以评估现有骨状况。考虑到手术和修复技术,使用Exocad软件对颧骨种植体进行虚拟手术规划,以实现最大功能和可持续性的目标。

结果

所有患者在术后15、30、45和90天进行随访,此后每月随访一次,以评估软组织愈合、感染、裂开、假体松动、进食效率和美观情况。所有15例患者的随访期为6至12个月。

结论

对于毛霉菌病后全上颌骨切除术患者,使用定制颧骨种植体具有骨增量最小、恢复功能所需时间减少以及减少多次手术的经济负担等优点。因此,定制颧骨种植体可能是毛霉菌病后全上颌骨切除术患者假体修复的一种有效替代治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bfb/10082691/1e1a44855c1b/12663_2023_1847_Fig1_HTML.jpg

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