Tags

Type your tag names separated by a space and hit enter

Patient-specific sub-periosteal zygoma implant for prosthetic rehabilitation of large maxillary defects after oncological resection.
Int J Oral Maxillofac Surg 2019; 48(1):115-117IJ

Abstract

A 74-year-old woman needed a subtotal bilateral maxillectomy due to squamous cell carcinoma of the palate. Immediate and secondary reconstruction of the defect was not feasible, so the defect was closed with an obturator prosthesis wired to the zygoma complex. To improve the patient's severely impaired speech and swallowing, a patient-specific sub-periosteal implant (psSPI) was designed that matched the remnants of the zygoma complex. First, the patient's post-surgical anatomy was visualized through segmentation of the pre- and post-maxillectomy computed tomography data. Next, based on the data, a customized zygoma-supported framework was designed to support the obturator prosthesis. Surgical guides for intraoperative navigation were designed and three-dimensionally printed, along with an obturator prosthesis to fit the planned outcome situation. The preoperatively manufactured psSPI and obturator prosthesis matched the intraoperative conditions. The postoperative results were favourable; within a week after surgery the patient could speak and swallow normally without nasal leakage. No problems occurred during follow-up. These results indicate that a psSPI-retained prosthesis can be considered for the restoration of speech and oral functioning in cases with a largely compromised maxillary bone anatomy, accompanied by impaired oral functioning and no feasible conventional reconstruction options.

Authors+Show Affiliations

Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Centre Groningen, Groningen, The Netherlands.Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Centre Groningen, Groningen, The Netherlands.Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Centre Groningen, Groningen, The Netherlands.Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Centre Groningen, Groningen, The Netherlands. Electronic address: g.m.raghoebar@umcg.nl.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

30041913

Citation

Vosselman, N, et al. "Patient-specific Sub-periosteal Zygoma Implant for Prosthetic Rehabilitation of Large Maxillary Defects After Oncological Resection." International Journal of Oral and Maxillofacial Surgery, vol. 48, no. 1, 2019, pp. 115-117.
Vosselman N, Merema BJ, Schepman KP, et al. Patient-specific sub-periosteal zygoma implant for prosthetic rehabilitation of large maxillary defects after oncological resection. Int J Oral Maxillofac Surg. 2019;48(1):115-117.
Vosselman, N., Merema, B. J., Schepman, K. P., & Raghoebar, G. M. (2019). Patient-specific sub-periosteal zygoma implant for prosthetic rehabilitation of large maxillary defects after oncological resection. International Journal of Oral and Maxillofacial Surgery, 48(1), pp. 115-117. doi:10.1016/j.ijom.2018.06.010.
Vosselman N, et al. Patient-specific Sub-periosteal Zygoma Implant for Prosthetic Rehabilitation of Large Maxillary Defects After Oncological Resection. Int J Oral Maxillofac Surg. 2019;48(1):115-117. PubMed PMID: 30041913.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patient-specific sub-periosteal zygoma implant for prosthetic rehabilitation of large maxillary defects after oncological resection. AU - Vosselman,N, AU - Merema,B J, AU - Schepman,K P, AU - Raghoebar,G M, Y1 - 2018/07/02/ PY - 2018/01/15/received PY - 2018/05/04/revised PY - 2018/06/20/accepted PY - 2018/7/26/pubmed PY - 2019/5/21/medline PY - 2018/7/26/entrez KW - computer-aided design KW - maxillary obturator KW - maxillectomy KW - sub-periosteal KW - three-dimensional KW - zygomatic implant SP - 115 EP - 117 JF - International journal of oral and maxillofacial surgery JO - Int J Oral Maxillofac Surg VL - 48 IS - 1 N2 - A 74-year-old woman needed a subtotal bilateral maxillectomy due to squamous cell carcinoma of the palate. Immediate and secondary reconstruction of the defect was not feasible, so the defect was closed with an obturator prosthesis wired to the zygoma complex. To improve the patient's severely impaired speech and swallowing, a patient-specific sub-periosteal implant (psSPI) was designed that matched the remnants of the zygoma complex. First, the patient's post-surgical anatomy was visualized through segmentation of the pre- and post-maxillectomy computed tomography data. Next, based on the data, a customized zygoma-supported framework was designed to support the obturator prosthesis. Surgical guides for intraoperative navigation were designed and three-dimensionally printed, along with an obturator prosthesis to fit the planned outcome situation. The preoperatively manufactured psSPI and obturator prosthesis matched the intraoperative conditions. The postoperative results were favourable; within a week after surgery the patient could speak and swallow normally without nasal leakage. No problems occurred during follow-up. These results indicate that a psSPI-retained prosthesis can be considered for the restoration of speech and oral functioning in cases with a largely compromised maxillary bone anatomy, accompanied by impaired oral functioning and no feasible conventional reconstruction options. SN - 1399-0020 UR - https://www.unboundmedicine.com/medline/citation/30041913/Patient_specific_sub_periosteal_zygoma_implant_for_prosthetic_rehabilitation_of_large_maxillary_defects_after_oncological_resection_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0901-5027(18)30237-6 DB - PRIME DP - Unbound Medicine ER -