Implant-retained nasal prosthesis for reconstruction of large rhinectomy defects: the Salisbury experience.
The authors report their experience with 34 patients who had large full thickness nasal defects reconstructed with an implant-retained prosthesis. Their technique of modifying post-rhinectomy defects is described and factors influencing implant success are evaluated. 111 implants were placed to retain a nasal prosthesis. Age, sex and tumour histology did not affect the outcome. Smoking, extent of rhinectomy, use of radiotherapy (pre- and post-implant), hyperbaric oxygen, length and location of the implant and type of retention (bar/magnets) influenced implant success. The overall success rate was 89% (99/111); 94% in patients who did not receive radiotherapy and 86% in those who did. The prosthesis was in place in all patients (100%) at the time of last follow up. Post-rhinectomy defect modification enables adequate access for safe placement of long implants with good primary stability and helps the maintenance of good hygiene (further enhanced by the use of skin grafts). The authors think implant-retained prosthesis is a reliable option for reconstructing large full thickness rhinectomy defects. They suggest their technique of modifying the defect, use of long implants and magnets for retention is responsible for the high success rate of implants used to retain a nasal prosthesis.
Department of Oral & Maxillofacial Surgery, Odstock Centre for Burns, Plastic and Maxillofacial Surgery, Salisbury District Hospital, Salisbury SP2 8PJ, United Kingdom. mgethu@hotmail.com
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Ethunandan
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Downie
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Flood
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000534:rehabilitation / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006931:Hyperbaric Oxygenation; D008280:Magnetics / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery; D009666:Nose / Q000601:surgery; D009669:Nose Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012737:Sex Factors; D017592:Skin Care; D016038:Skin Transplantation; D012907:Smoking; D016896:Treatment Outcome; D014420:Turbinates / Q000601:surgery