RESUMO
Extraoral maxillofacial rehabilitation for compromised or lost facial anatomy resulting from the surgical eradication of malignancy, trauma, or congenital anomalies is commonly accomplished with a silicone prosthesis. However, with increasing size and weight, a silicone prosthesis can lose retention. This report presents 2 patient treatments to introduce a fabrication and retention method for a lightweight acrylic resin facial prosthesis. The prosthesis was fabricated by bonding an acrylic resin facial shell to a computer-edited facial image printed with iron-on transfers. The completed prosthesis was attached to the skin with medical-grade double-sided adhesive tape, which maintained a tight marginal seal even when in contact with saliva and water. The strong prosthetic retention of the lightweight prosthesis enabled orofacial and speech rehabilitation, which makes it a promising alternative to the conventional silicone prosthesis, especially for the restoration of extensive maxillofacial defects.
Assuntos
Resinas Acrílicas , Materiais Biocompatíveis , Prótese Maxilofacial , Desenho de Prótese , Retenção da Prótese , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Masculino , Mandíbula/cirurgia , Neoplasias Maxilares/radioterapia , Neoplasias Maxilares/cirurgia , Recidiva Local de Neoplasia/radioterapia , Recidiva Local de Neoplasia/cirurgia , Osteorradionecrose/cirurgiaRESUMO
PURPOSE: The purpose of this study was to investigate the effect of stereotactic radiosurgery on local control and organ preservation in cases of primary head and neck cancer. PATIENTS AND METHODS: In this retrospective study, 14 patients with a mean age of 73 years were treated between March 2006 and September 2007 with stereotactic radiosurgery for the management of primary head and neck cancer. The patients had biopsy confirmation of disease before treatment and all patients were confirmed with squamous cell carcinoma. The staging consisted of T2 (5 cases), T3 (3 cases), T4 (6 cases), N0 (13 cases), and N1 (1 case). Marginal doses were 3,500 to 4,200 cGy in 3 or 5 fractions. The outcome was assessed according to Response Evaluation Criteria in Solid Tumors criteria based on magnetic resonance imaging and positron emission tomography/computed tomography. RESULTS: Significant tumor reduction was noted at the third month of follow-up with 5 complete responses and 9 partial responses. At a mean follow-up of 36 months (range, 14-40 mo) the local control and overall survival rates were 71.4% (10/14) and 78.6% (11/14), respectively. CONCLUSIONS: These results show the feasibility of using stereotactic radiosurgery for primary head and neck cancer and its potential benefit in local control and organ preservation.