Image-Guided Placement of Osseointegrated Implants for Challenging Auricular, Orbital, and Rhinectomy Defects.

Published

Journal Article

OBJECTIVES: Prosthetic reconstruction can restore the preoperative form and function after surgery for head and neck malignancies. We demonstrate the use of preoperative planning and intraoperative image guidance for placement of osseointegrated implants to restore craniofacial defects. METHODS: A retrospective review of patients with craniofacial defects treated with image-guided placement of osseointegrated prosthetic implants was performed. RESULTS: Case 1: 55-year-old male who underwent total auriculectomy with anterolateral thigh reconstruction. Case 2: 64-year-old male who required orbital exenteration and total auriculectomy with latissimus dorsi reconstruction. Case 3: 74-year-old male presented after a total rhinectomy. Cases 1 and 3 received adjuvant radiation prior to implantation. Case 2 underwent simultaneous placement of osseointegrated hearing and prosthetic implants. Computed tomography scans were used to perform preoperative planning to determine the optimal implant trajectories and sites. Complications included tissue overgrowth, delayed nonunion of implant, wound infection, and dehiscence. CONCLUSIONS: Defects following oncologic resection of head and neck malignancies can be difficult to achieve with native tissue alone. Osseointegrated implants offer an excellent means for reconstruction but can be challenging due to limited bone stock and anatomic landmarks. This can be overcome using intraoperative image guidance techniques for prosthetic reconstruction.

Full Text

Duke Authors

Cited Authors

  • Choi, KJ; Sajisevi, MB; McClennen, J; Kaylie, DM

Published Date

  • October 2016

Published In

Volume / Issue

  • 125 / 10

Start / End Page

  • 801 - 807

PubMed ID

  • 27307422

Pubmed Central ID

  • 27307422

Electronic International Standard Serial Number (EISSN)

  • 1943-572X

Digital Object Identifier (DOI)

  • 10.1177/0003489416654708

Language

  • eng

Conference Location

  • United States