Treatment outcome of bone‐anchored craniofacial prostheses after tumor surgery

• Published in: Cancer Vol. 92; no. 12; pp. 3045 - 3050
• Main Authors: Schoen, Pieter J., Raghoebar, Gerry M., van Oort, Robert P., Reintsema, Harry, van der Laan, Bernard F. A. M., Burlage, Fred R., Roodenburg, Jan L. N., Vissink, Arjan
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 15.12.2001; Wiley-Liss
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Bone Screws; craniofacial implants; Ear Neoplasms - pathology; Ear Neoplasms - radiotherapy; Ear Neoplasms - surgery; facial prosthesis; Female; Follow-Up Studies; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Male; Maxillofacial surgery. Dental surgery. Orthodontics; Medical sciences; Middle Aged; oncology; Orbital Implants; Orbital Neoplasms - pathology; Orbital Neoplasms - radiotherapy; Orbital Neoplasms - surgery; Patient Satisfaction; Postoperative Complications; Prostheses and Implants; Quality of Life; radiation therapy; Radiotherapy - adverse effects; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Human; Implant; Stomatology; Prosthesis; Diseases of the osteoarticular system; Radiotherapy; Quality of life; Treatment; Surgery; Tumor; Craniofacial; Bone defect; Bone; Anchoring
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(20011215)92:12<3045::AID-CNCR10147>3.0.CO;2-K

BACKGROUND Percutaneous endosseous implants have acquired an important place in the prosthetic rehabilitation of patients with craniofacial defects. The objective of this study was to evaluate the clinical outcome of the use of endosseous implants in the orbital and auricular region as well as to assess the satisfaction of patients with implant‐retained craniofacial prostheses after tumor surgery. METHODS The clinical outcome and patient satisfaction of implant‐retained prostheses in the auricular and orbital region were evaluated in a group of 26 patients with facial defects after tumor surgery by using standardized questionnaires and a clinical assessment. Twelve patients (n = 31 implants) received the implants during ablative tumor surgery, from which 7 patients (n = 20 implants) were treated with radiation therapy after surgery (mean, 65 grays [Gy]). Fourteen patients (n = 44 implants) received the implants after the tumor surgery, from which 5 patients (n = 21 implants) were irradiated after ablative surgery (mean, 54.4 Gy), but before implant placement. RESULTS No implants were lost in patients who had not undergone irradiation (100%), whereas 5 implants were lost in the irradiated group (87.8%). The overall implant survival rate was 93.3%. The peri‐implant tissues had a healthy appearance, and no cases of osteoradionecrosis occurred. When compared with patients treated with conventional adhesive retained facial prostheses, satisfaction was higher in patients treated with implant‐retained facial prostheses. CONCLUSIONS From this study, it is concluded that implant‐retained facial prostheses are better tolerated than adhesive retained prostheses and offer an improvement in the quality of life. Radiotherapy is not a contraindication for the use of osseointegrated implants in the maxillofacial region, but the loss of implants is higher than in nonirradiated sites. Cancer 2001;92:3045–50. © 2001 American Cancer Society. Implant‐retained facial prostheses are significantly preferred by patients above adhesive retained prostheses and offer an improvement in quality of life. Radiotherapy is not a contraindication for the use of osseointegrated implants in the maxillofacial region, although the loss of implants is higher in irradiated sites than in nonirradiated sites.