ダイナミックチタンメッシュを用いた上顎全摘後の眼窩底再建

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  • Orbital Floor Reconstruction Using a Dynamic Titanium Mesh Following a Total Maxillectomy
  • 臨床 ダイナミックチタンメッシュを用いた上顎全摘後の眼窩底再建
  • リンショウ ダイナミックチタンメッシュ オ モチイタ ジョウガク ゼンテキゴ ノ ガンカテイ サイケン

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<p>When a total maxillectomy is performed in patients with maxillary cancer, it is important to preserve visual function and maintain the patient’s facial features, since both orbital floors are removed. Various reconstruction methods have been reported. We have performed reconstructions of the orbital floor using a dynamic titanium mesh. The results have been satisfactory in terms of function and cosmetic appearance, since neither diplopia nor infectious symptoms have been observed and minimal post-surgical cheek deformation has occurred. The prosthesis were prepared so as to cover the resected area of the hard palate. The removal of the prosthesis facilitated observations of the cavity. Also, the presence or absence of recurrences and the condition of the reconstruction site could be assessed visually. The titanium mesh that was employed was useful for preserving postoperative visual function, since it has a high biological affinity and can be easily used to replicate the 3D structure of the orbital floors. Compared with a vascularized composite-free tissue transfer, surgery using this mesh requires only a short operative time and the sacrifice of fewer autografts. In contrast to bone grafting, the restoration of ocular alignment is possible, since the mesh can easily replicate the 3D structure of the orbital floors. The mesh, however, may be exposed on the surface of the skin or cause infection if used over a wide area extending to the zygomatic bones, since it is an artificial material. It is important to take the area of reconstruction into consideration when using this mesh, as in the present cases. Here, we report three postoperative cases with follow-up periods of more than 5 years. A lengthy and meticulous follow-up period is necessary for such cases.</p>

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