骨膜下种植体用于颞骨缺损的耳廓重建。

IF 1.6 4区 医学 Q3 SURGERY
Yu Jin Jeong, Masako Dunn, Sophie Fleming, Richard Thomas, Dale Howes, Jonathan Clark, Tsu-Hui Low
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引用次数: 0

摘要

背景:虽然在耳廓重建领域已经建立了几种技术,但对于颞骨严重缺损的病例,特别是因恶性肿瘤切除外侧颞骨后,这些方法往往不足以恢复审美功能。本病例系列描述了在澳大利亚三级癌症转诊中心使用骨膜下植入物(IPS植入颅面Epithesis, KLS Martin Group, Tuttlingen, Germany)进行耳廓重建的新方法。方法:在我们的机构描述了虚拟手术计划(VSP)过程和手术技术骨膜下种植体保留耳廓义肢重建与自由皮瓣。本文介绍了2023年11月至2024年7月期间的一系列回顾性病例。结果:3例患者行骨膜下种植体耳廓重建。重建指征包括耳廓基底细胞癌(1例)和累及耳道的鳞状细胞癌(2例)。每位患者接受一个骨膜下种植体(每个种植体框架n = 3个固定桩)。采用大腿前外侧游离皮瓣(n = 2)或前臂桡侧游离皮瓣(n = 1)进行重建。在我们的队列中没有观察到手术并发症或种植体丢失。2例患者术后4个月和7个月成功植入耳廓假体,并在随访中保留功能性假体。一名患者不幸死于远端疾病在9个月前假体可以制造。结论:我们的研究支持在恶性颞骨切除后采用骨膜下种植体保留的人工耳廓重建的可行性。它为肿瘤切除后的可靠和强健的美学康复提供了机会。需要长期数据来确定与该技术的新应用相关的可靠性和长期生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Subperiosteal Implants for Auricular Reconstruction in the Setting of Significant Temporal Bone Defects.

Background: While several techniques have been established in the field of auricular reconstruction, these methods are often inadequate in restoring aesthetic function for cases involving significant defects of the temporal bone, particularly after a lateral temporal bone resection for malignancy. This case series describes a novel approach of auricular reconstruction using subperiosteal implants (IPS Implants Craniofacial Epithesis, KLS Martin Group, Tuttlingen, Germany) at an Australian tertiary cancer referral centre.

Methodology: The virtual surgical planning (VSP) process and operative technique for subperiosteal implant-retained auricular prosthetic reconstruction in conjunction with a free flap at our institution is described. A retrospective series of cases performed from November 2023 to July 2024 is presented.

Results: Three patients underwent auricular reconstruction with subperiosteal implants. Indications for reconstruction included basal cell carcinoma of the auricle (n = 1) and squamous cell carcinoma involving the ear canals (n = 2). Each patient received one subperiosteal implant (n = 3 retention posts per implant framework). Reconstruction was undertaken with an anterolateral thigh free flap (n = 2) or a radial forearm free flap with adipofascial extension (n = 1). No surgical complications or implant losses were observed in our cohort. Two patients underwent successful loading of an auricular prosthesis 4 and 7 months postoperatively, and retained a functional prosthesis on follow-up. One patient unfortunately died of distant disease at 9 months before prosthesis could be fabricated.

Conclusion: Our series supports the feasibility of a subperiosteal implant-retained prosthetic auricular reconstruction after a temporal bone resection in the setting of malignancy. It provides opportunity for a reliable and robust aesthetic rehabilitation after oncological resection. Long-term data is required to establish the reliability and long-term quality-of-life outcomes associated with this novel application of this technique.

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来源期刊
ANZ Journal of Surgery
ANZ Journal of Surgery 医学-外科
CiteScore
2.50
自引率
11.80%
发文量
720
审稿时长
2 months
期刊介绍: ANZ Journal of Surgery is published by Wiley on behalf of the Royal Australasian College of Surgeons to provide a medium for the publication of peer-reviewed original contributions related to clinical practice and/or research in all fields of surgery and related disciplines. It also provides a programme of continuing education for surgeons. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.
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