Gugliotta Ylenia, Zavattero Emanuele, Ramieri Guglielmo, Borbon Claudia, Gerbino Giovanni
Maxillo-Facial Surgery Unit, Department of Surgical Sciences, AOU Città della Salute e della Scienza, University of Turin, Corso Bramante 88, 10126 Torino, Italy.
J Pers Med. 2024 Aug 10;14(8):849. doi: 10.3390/jpm14080849.
Reconstructing cranio-maxillo-facial defects presents significant challenges. This study evaluates the results of polyetheretherketone patient-specific implants (PEEK PSIs) in primary and secondary cranio-maxillo-facial reconstructions, with a focus on aesthetic and functional outcomes and long-term complications.
From October 2009 to February 2023, 45 patients underwent cranio-maxillo-facial reconstructions with PSIs. Patients aged 18 years or older, with a minimum follow-up period of 12 months, were included. The morpho-functional outcome was evaluated through a modified Katsuragy Scale, the Visual Analogue Scale (VAS) for pain, and four FACE-Q|Aesthetics© scales.
In total, 44 PSIs were placed in 37 patients (51.3% males; mean age 45.1 years). The main cause of the defect was the resection of a tumor (55.4%). Mean follow-up was 78.6 months. Clinical evaluations showed an improvement in the postoperative period both in patient's and surgeon's scores (: 0.01 and : 0.002, respectively). Subgroup analysis confirmed a significant improvement in patients undergoing cranioplasty ( = 0.02) and mandible reconstruction ( = 0.03). No cases of prosthesis dislocation, rupture, or long-term infection were recorded.
PEEK PSIs offer significant advantages in craniofacial reconstructions. Despite challenges in predicting soft tissue adaptation, overall patient satisfaction was high with no long-term complications. Future improvements should focus on predicting and enhancing soft tissue adaptations.
颅颌面缺损的重建面临重大挑战。本研究评估了聚醚醚酮个性化植入物(PEEK PSIs)在原发性和继发性颅颌面重建中的效果,重点关注美学和功能结果以及长期并发症。
2009年10月至2023年2月,45例患者接受了PSI颅颌面重建手术。纳入年龄在18岁及以上、最短随访期为12个月的患者。通过改良的Katsuragy量表、疼痛视觉模拟量表(VAS)和四个FACE-Q|美学量表评估形态功能结果。
共为37例患者(51.3%为男性;平均年龄45.1岁)植入了44个PSI。缺损的主要原因是肿瘤切除(55.4%)。平均随访78.6个月。临床评估显示,术后患者和外科医生的评分均有改善(分别为:0.01和:0.002)。亚组分析证实,接受颅骨成形术(=0.02)和下颌骨重建(=0.03)的患者有显著改善。未记录到假体脱位、破裂或长期感染的病例。
PEEK PSIs在颅面重建中具有显著优势。尽管在预测软组织适应性方面存在挑战,但患者总体满意度较高,且无长期并发症。未来的改进应集中在预测和增强软组织适应性方面。