Patient-specific PEEK implants for immediate restoration of temporal fossa after maxillary reconstruction with temporalis muscle flap / 대한악안면성형재건외과학회지

Background@#Temporal hollowing is a common complication following the rotation of the temporalis muscle that leaves the patient with a cosmetic impairment. Several alloplastic materials have been used to reconstruct the donor site; however, these implants need meticulous adaptation to conform the periphery of the defect and restore the contour of the temporal area. The aim of this study was to assess the use of patient-specific polyetheretherketone (PEEK) temporal implants to prevent temporal hollowing following the use of full temporalis muscle flap for large maxillary defects reconstruction. @*Methods@#This was a prospective study conducted on eight patients with major maxillary defects indicating the need of reconstruction with full temporalis muscle flap or any lesion indicating major maxillary resection and immediate reconstruction with total temporalis muscle flap. For each patient, a patient-specific PEEK implant was fabricated using virtual planning and milled from PEEK blocks. In the surgical theater, the temporalis muscle was exposed, elevated, and transferred to the maxilla. After the temporalis muscle transfer, PEEK implants were fixed in place to prevent temporal hollowing. @*Results@#The surgical procedures were uneventful for all patients. The esthetic result was satisfactory with no post-operative complications except in one patient where seroma occurred after 2 weeks and resolved after serial aspiration. @*Conclusion@#Patient-specific PEEK implant appears to facilitate the surgical procedures eliminate several meticulous steps that are mainly based on the surgeon’s experience.

Computer-guided buccal cortical plate separation for removal of calcified benign odontogenic tumors affecting the mandibular angle region / 대한악안면성형재건외과학회지

Purpose@#Surgical removal of intra-bony calcific benign lesions is technically challenging regarding its accessibility, proximity to vital structures, and deteriorating effect on the remaining bony structures. @*Methods@#Computer-guided buccal cortical plate separation was performed for ten patients using patient-specific osteotomy locating guides and pre-bent plates. The guide was designed to outline the osteotomy, the buccal cortical plate was separated, the lesion was removed, and finally, the pre-bent plates were used to fix the separated cortex. @*Results@#Surgical procedures were uneventful for all patients, operation time was 39.5 ± 13.01 min, postoperative pain decreased within the follow-up time intervals, and there was a statistical significant difference between the time intervals (P value < 0.001). Edema and trismus were acceptable. One case showed nerve affection which resolved after 4 weeks. @*Conclusion@#Computer-guided buccal cortical plate separation for removal of intra-bony calcified benign lesions provides a promising approach, especially for inexperienced surgeons.