Implant-retained nasal prosthesis for reconstruction of large rhinectomy defects: the Salisbury experience

• Published in: International journal of oral and maxillofacial surgery 2010-04, Vol.39 (4), p.343-349
• Main Authors: Ethunandan, M, Downie, I, Flood, T
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Basal Cell - rehabilitation; Carcinoma, Basal Cell - surgery; Carcinoma, Squamous Cell - rehabilitation; Carcinoma, Squamous Cell - surgery; craniofacial implants; Dentistry; Female; Follow-Up Studies; Humans; Hyperbaric Oxygenation; Magnetics - instrumentation; Male; Medical sciences; Middle Aged; nasal prosthesis; nasal reconstruction; Nasal Septum - surgery; Nose - surgery; Nose Neoplasms - rehabilitation; Nose Neoplasms - surgery; osseointegration; Otorhinolaryngology. Stomatology; Prostheses and Implants; Prosthesis Design; Prosthesis Failure; Prosthesis Implantation - instrumentation; Prosthesis Implantation - methods; radiotherapy; Radiotherapy, Adjuvant; Reconstructive Surgical Procedures - methods; Retrospective Studies; rhinectomy; Sex Factors; Skin Care; Skin Transplantation; Smoking; Surgery; Treatment Outcome; Turbinates - surgery
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2010.01.003

Abstract 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.