General and Treatment-Specific Outcomes with Osseointegrated Implants in Auricular, Nasal, and Orbital Prosthetic Reconstruction.

Abstract

Background: Osseointegrated implants outside of dental restoration remain an integral area of facial reconstruction in which more outcomes data is needed. We aimed to describe our 13-year experience using osseointegrated implants for orbital, nasal, and auricular reconstruction, looking at general outcomes, including radiated and surgically manipulated bone.

Methods: This retrospective chart review covered demographics and outcomes from January 2008 to August 2021 in patients who underwent an orbital exenteration, partial or total rhinectomy, and partial or total auriculectomy with subsequent osseointegrated implant placement. We hypothesized radiation would increase the failure rate of implants and prostheses.

Results: There were 79 implants placed in 27 patients, with over half of the patients requiring implants for reconstruction because of malignancy. The success rate was 86%. Complications were uncommon. Only 2 (7.4%) patients were unable to use their prosthesis. Prior radiation and surgery to the bone were associated with an increased risk of loss of implant (p = 0.008 and p = 0.007, respectively) but not associated with other complications or prosthesis non-viability.

Conclusions: Osseointegrated implants are a reliable, permanent option for a realistic prosthesis. Radiation and prior surgery are significantly associated with an increased risk of implant failure but not associated with the inability to use the prosthesis. Regardless of prior treatments, bone-retained implants should be considered in facial reconstruction, especially after failing autologous repair or with concerns for cosmetic outcomes.