ABSTRACT
Extensive bilateral midfacial defects including the upper jaw, palate, and sinuses present a formidable reconstructive challenge. Prosthetic restorations require a solid anchor point to be successful, since orofacial motion would otherwise cause instability of the prosthesis. We report on a series of eight patients who underwent transmalar placement of a Steinmann pin at the time of definitive tumor resection. The Steinmann pin was used immediately to securely anchor a prosthesis to the skull base. The maximum follow-up time is 9 years. The Steinmann pin has remained firmly anchored without significant loosening in six of these eight patients, and no major complications have resulted from its use. In conclusion, the transmalar Steinmann pin is an effective and immediate single-stage method of permanently retaining a midface prosthesis.
Subject(s)
Maxilla/surgery , Palate/surgery , Paranasal Sinuses/surgery , Adolescent , Adult , Aged , Humans , Middle Aged , Palatal Obturators , Prostheses and ImplantsABSTRACT
With previous prosthetic restorations of bilateral maxillary resections, tissue erosion and bleeding on the cephalic parts of the cavity have been caused by movement and pressure from the prosthesis. Retention of a prosthesis is a major determinant in its successful use. Physical and psychologic stresses are common when one is unable to use a prosthesis comfortably. The use of a musculocutaneous flap and an obturator prosthesis had provided near-immediate reconstruction of a massive midfacial defect. This method of reconstruction resulted in soft tissue replacement for appearance and functional rehabilitation of the upper lip while maintaining sound oncologic principles.
Subject(s)
Maxillary Sinus Neoplasms/rehabilitation , Maxillofacial Prosthesis , Nose , Prostheses and Implants , Adult , Bone Nails , Humans , Magnetics , Male , Maxillary Sinus Neoplasms/surgery , Melanoma/rehabilitation , Melanoma/surgery , Nose/surgery , Nose Neoplasms/rehabilitation , Nose Neoplasms/surgery , Palatal Neoplasms/rehabilitation , Palatal Neoplasms/surgery , Palatal Obturators , Prosthesis Failure , Prosthesis Fitting , Surgery, Plastic/methods , Surgical Flaps/methodsABSTRACT
It appears that the palatal lift prosthesis is an effective prosthesis to improve palatopharyngeal incompetence in selected patients. Despite the inconvenience and problems associated with a prosthesis, this procedure is indicated for selected patients who have anatomically normal palates that are dysfunctional. The ultimate benefit of the palatal lift prostheses to the speech of the patients is not the subject of this report. However, it should be noted that many patients can benefit from speech therapy after a satisfactory prosthetic result has been achieved.
