RESUMEN
We report the 19-year postoperative course of a patient whose maxillary defect was reconstructed with maxillofacial implant-retained facial prostheses. The patient received 60 Gy of radiation therapy. Adjunctive hyperbaric oxygen therapy was administered and four 4.0-mm long maxillofacial implants were inserted. Four years and 6 months after insertion surgery, two of the four implants were lost and the others showed bone regression in the surrounding bone. All implants were replaced with Epitec System maxillofacial implants placed in non-irradiated bone. Eleven years and 6 months after replacement, the Epitec System has been maintaining good and firm osseointegration. Appropriate selection of implant sites and no history of radiation therapy are keys to successful implant reconstruction. However, adjunctive hyperbaric oxygen therapy is believed to be effective, osseointegrated implant should be inserted at a point appropriately distant from an irradiated lesion.
Asunto(s)
Neoplasias Maxilares/cirugía , Implantación de Prótesis Maxilofacial/métodos , Prótesis Maxilofacial , Radioterapia/efectos adversos , Anciano , Femenino , Humanos , Oxigenoterapia Hiperbárica , Maxilar/cirugía , Órbita/cirugía , Oseointegración , Falla de Prótesis , Dosificación Radioterapéutica , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Deglución , Prótesis Maxilofacial , Hueso Paladar , Habla , Carcinoma de Células Escamosas/fisiopatología , Carcinoma de Células Escamosas/rehabilitación , Dentadura Completa Inferior , Dentadura Parcial Removible , Femenino , Glosectomía/rehabilitación , Humanos , Magnetismo/uso terapéutico , Implantación de Prótesis Maxilofacial/métodos , Persona de Mediana Edad , Recurrencia Local de Neoplasia/fisiopatología , Recurrencia Local de Neoplasia/rehabilitación , Diseño de Prótesis , Neoplasias de la Lengua/fisiopatología , Neoplasias de la Lengua/rehabilitaciónRESUMEN
Reconstructing a cancer patient's head and neck region can be challenging for the restorative team because of the size of the defect and the tumorous condition of the remaining anatomical structures. This article presents a case that uses remaining healthy tissue, along with intraoral and extraoral devices, to deliver a sophisticated prosthetic device designed to restore physical function.