1
|
Troeltzsch D, Neckel N, Neyer J, Preissner S, Raguse JD, Motzkus Y, Heiland M, Vach K, Nahles S. Clinical and social success in epithetic ear rehabilitation - Retrospectively evaluating the long-term survival of auricular implants. J Craniomaxillofac Surg 2024; 52:884-889. [PMID: 39019745 DOI: 10.1016/j.jcms.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/25/2023] [Accepted: 02/01/2024] [Indexed: 07/19/2024] Open
Abstract
PURPOSE The aim of this study was to evaluate existing staging recommendations for peri-implantitis and its applicability for auricular bone anchoring. MATERIALS AND METHODS In this cross-sectional study, 44 patients treated with 47 ear epitheses and 128 implants were analyzed over 191.6 months (mean). Peri-implant sulcus depth, sulcus fluid flow rate, and peri-implant skin reaction, as well as cleaning habits and patients' quality of life, were analyzed. Mixed effect linear and mixed effect ordered logistic regression models were used. RESULTS Two of the 128 implants were lost (1.6 %). A total of 14.5 % of all patients presented light erythemas, 19.4 % showed stage 2, 4.8 % stage 3, and 12.9 % an acute infection according to Holgers. A correlation between skin reaction and sulcus fluid flow rate was observed, when grouping patients with acute signs of inflammation. Concerning patient satisfaction, 58.1 % of the patients were highly satisfied with their epitheses, 39.5 % very satisfied, and one patient was just satisfied. Younger age correlated with lower satisfaction rates. CONCLUSION Implant-retained auricular epitheses are a safe, highly sufficient and satisfying way of extending ear reconstruction. Sulcus depth and skin reaction are quick and valuable assessment tools in auricular implants, but skin reaction alone was clinically insufficient to predict peri-implant pocket inflammation.
Collapse
Affiliation(s)
- D Troeltzsch
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. M. Heiland), Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - N Neckel
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. M. Heiland), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Neyer
- Department of Oral and Maxillofacial Surgery, (Head: Dr. Dr. T. Teltzrow), Klinikum Ernst von Bergmann Gemeinnützige GmbH, Charlottenstraße 72, 14467, Potsdam, Germany
| | - Saskia Preissner
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. M. Heiland), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J-D Raguse
- Department of Oral and Maxillofacial Surgery, (Head: PD Dr. Dr. J-D Raguse), Fachklinik Hornheide, Dorbaumstrasse 300, 48157, Münster, Germany
| | - Y Motzkus
- Berliner Zentrum für Künstliche Gesichtsteile/ BZkG, Augustenburger Platz 1, 13353, Berlin, Germany
| | - M Heiland
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. M. Heiland), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - K Vach
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - S Nahles
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. M. Heiland), Charité-Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
2
|
Swanepoel HF, Matthews HS, Claes P, Vandermeulen D, Oettlé AC. A statistical shape model for estimating missing soft tissues of the face in a black South African population. J Prosthodont 2024; 33:565-573. [PMID: 37589169 DOI: 10.1111/jopr.13746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 07/30/2023] [Accepted: 08/11/2023] [Indexed: 08/18/2023] Open
Abstract
PURPOSE Facial disfigurement may affect the quality of life of many patients. Facial prostheses are often used as an adjuvant to surgical intervention and may sometimes be the only viable treatment option. Traditional methods for designing soft-tissue facial prostheses are time-consuming and subjective, while existing digital techniques are based on mirroring of contralateral features of the patient, or the use of existing feature templates/models that may not be readily available. We aim to support the objective and semi-automated design of facial prostheses with primary application to midline or bilateral defect restoration where no contralateral features are present. Specifically, we developed and validated a statistical shape model (SSM) for estimating the shape of missing facial soft tissue segments, from any intact parts of the face. MATERIALS AND METHODS An SSM of 3D facial variations was built from meshes extracted from computed tomography and cone beam computed tomography images of a black South African sample (n = 235) without facial disfigurement. Various types of facial defects were simulated, and the missing parts were estimated automatically by a weighted fit of each mesh to the SSM. The estimated regions were compared to the original regions using color maps and root-mean-square (RMS) distances. RESULTS Root mean square errors (RMSE) for defect estimations of one orbit, partial nose, cheek, and lip were all below 1.71 mm. Errors for the full nose, bi-orbital defects, as well as small and large composite defects were between 2.10 and 2.58 mm. Statistically significant associations of age and type of defect with RMSE were observed, but not with sex or imaging modality. CONCLUSION This method can support the objective and semi-automated design of facial prostheses, specifically for defects in the midline, crossing the midline or bilateral defects, by facilitating time-consuming and skill-dependent aspects of prosthesis design.
Collapse
Affiliation(s)
| | - Harold S Matthews
- Laboratory for Imaging Genetics, Department of Human Genetics, Katholieke Universiteit, Leuven, Belgium
- Medical Imaging Research Center, Universitair Ziekenhuis, Leuven, Belgium
- Facial Sciences, Murdoch Children's Research Institute, Parkville, Australia
| | - Peter Claes
- Laboratory for Imaging Genetics, Department of Human Genetics, Katholieke Universiteit, Leuven, Belgium
- Medical Imaging Research Center, Universitair Ziekenhuis, Leuven, Belgium
- Facial Sciences, Murdoch Children's Research Institute, Parkville, Australia
- Department of Electrical Engineering, Katholieke Universiteit, Leuven, Belgium
| | - Dirk Vandermeulen
- Medical Imaging Research Center, Universitair Ziekenhuis, Leuven, Belgium
- Department of Electrical Engineering, Katholieke Universiteit, Leuven, Belgium
| | - Anna C Oettlé
- Department of Anatomy, University of Pretoria, Pretoria, South Africa
- Anatomy and Histology Department, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| |
Collapse
|
3
|
J L J, V M, Rangasamy J, Ramanarayanan V, Nair PK. Mechanical properties of tissue adhesives used for retaining extraoral silicone prostheses in maxillofacial defects: A systematic review. J Prosthet Dent 2024:S0022-3913(24)00223-3. [PMID: 38653691 DOI: 10.1016/j.prosdent.2024.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 03/16/2024] [Accepted: 03/18/2024] [Indexed: 04/25/2024]
Abstract
STATEMENT OF PROBLEM Different tissue adhesives are available for retaining extraoral silicone prostheses in maxillofacial defects. Comparative assessment of their mechanical properties will help the clinician select the right product for a specific clinical situation, but a systematic review is lacking. PURPOSE The purpose of this systematic review was to analyze the existing data in the literature regarding 5 mechanical properties of tissue adhesives for extraoral silicone prostheses: peel strength, tensile strength, shear strength, torsional strength, and tack. MATERIAL AND METHODS A manual and electronic search was performed in appropriate databases to identify relevant publications with specific inclusion and exclusion criteria. The retrieved studies were screened for eligibility using the title, abstract, and published full texts. To evaluate the risk of bias, a methodological quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Checklists for Randomized Controlled Trials. A custom data extraction template was used, and the results pooled using descriptive methods. RESULTS After screening, 15 articles, 5 in vitro studies, and 10 clinical studies were eligible for data extraction. In vitro studies assessed tack and peel bond strength. In contrast, clinical studies assessed peel strength, tensile strength, shear strength, and torsional strength through direct comparisons and in diverse settings. CONCLUSIONS The assessed studies showed considerable methodological heterogeneity. When silicone-based tissue adhesives (Secure2 Medical Adhesive; Factor II, Hollister Colostomy Adhesive; Hollister Inc, Dow Corning 355 Medical adhesives; Dow Corning Europe Inc) were compared with water-based adhesives (Pros-Aide Adhesive; ADM Tronics Inc, PSA 1; Cosmedica Ltd, Daro adhesive; Factor II, Epithane-3; Daro Products), the silicone-based adhesives showed a higher peel bond strength (PBS), while double-sided medical adhesive tapes showed lower PBS. A few studies evaluated variations in the PBS as being affected by the addition of stone wool fibers, immersion in water, application of skin protective dressings and adhesive removers, application of multiple layers of adhesive, and usage of urethane liner.
Collapse
Affiliation(s)
- Jaini J L
- Professor, Department of Prosthodontics, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, India.
| | - Manju V
- Professor and Head, Department of Prosthodontics, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Jayakumar Rangasamy
- Professor, Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Venkitachalam Ramanarayanan
- Reader, Department of Public health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Priya K Nair
- Reader, Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, India
| |
Collapse
|
4
|
Clark NW, Barrett DM, Kahmke RR, Powers DB, Woodard CR. Soft Tissue Trauma: Critical Recognition and Timing of Intervention in Emergency Presentations. Otolaryngol Clin North Am 2023; 56:1003-1012. [PMID: 37328319 DOI: 10.1016/j.otc.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The facial trauma surgeon will see a variety of facial injuries. Recognition of emergency cases and proper intervention is and this article aims to highlight those cases and the respective proper interventions.
Collapse
Affiliation(s)
- Nicholas W Clark
- Department of Head and Neck Surgery, Communication Sciences, Duke South Yellow Zone, 4000 DUMC Box 3805, Durham, NC 27710, USA
| | - Dane M Barrett
- Department of Head and Neck Surgery, Communication Sciences, Duke South Yellow Zone, 4000 DUMC Box 3805, Durham, NC 27710, USA
| | - Russel R Kahmke
- Department of Head and Neck Surgery, Communication Sciences, Duke South Yellow Zone, 4000 DUMC Box 3805, Durham, NC 27710, USA
| | - David B Powers
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, DUMC 2955, Durham, NC 27710, USA
| | - Charles R Woodard
- Department of Head and Neck Surgery, Communication Sciences, Duke South Yellow Zone, 4000 DUMC Box 3805, Durham, NC 27710, USA.
| |
Collapse
|
5
|
Singh PN, Byram PK, Das L, Chakravorty N. Natural Polymer-Based Thin Film Strategies for Skin Regeneration in Lieu of Regenerative Dentistry. Tissue Eng Part C Methods 2023; 29:242-256. [PMID: 37171125 DOI: 10.1089/ten.tec.2023.0070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
Wound healing (WH) is a complex and dynamic process that comprises of a series of molecular and cellular events that occur after tissue injury. The injuries of the maxillofacial and oral region caused by trauma or surgery result in undesirable WH such as delayed wound closure and formation of scar tissue. Skin tissue engineering (TE)/regeneration is an emerging approach toward faster, superior, and more effective resolution of clinically significant wounds effectively. A multitude of TE principles approaches are being put to action for the fabrication of hydrogels, electrospun sheets, 3D scaffolds, and thin films that can be used as wound dressings materials, sutures, or skin substitutes. Thin films are advantageous over other materials owing to their flexibility, ability to provide a barrier against external contamination, easy gaseous exchange, and easy monitoring of wounds. This review focuses on wound-dressing films and their significance and discusses various fabrication techniques. In addition, we explore various natural biopolymers that can be used for fabrication of skin TE materials. Impact Statement In this review article, critical evaluations of natural polymers used in skin regeneration were discussed. Further, the fabrication technology of the 2D and 3D material in wound healing were discussed.
Collapse
Affiliation(s)
| | | | - Lopamudra Das
- School of Medical Science and Technology, IIT Kharagpur, Kharagpur, India
| | | |
Collapse
|
6
|
Halily S, Amine KM, Oukessou Y, Rouadi S, Abada R, Roubal M, Mahtar M. An extensive squamous cell carcinoma of the auricle: From curative to reconstructive treatment. A case report. Int J Surg Case Rep 2022; 97:107413. [PMID: 35933948 PMCID: PMC9403086 DOI: 10.1016/j.ijscr.2022.107413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 07/10/2022] [Accepted: 07/10/2022] [Indexed: 02/07/2023] Open
Abstract
Squamous cell carcinoma (SCC) of the auricle is a rare and aggressive entity of cell carcinomas. It is mostly identified in older males with history of sun exposure. After histopathological confirmation, the initial assessment which consists of clinical and radiological evaluation will determine the therapeutic strategy. We report the case of a neglected SCC of the left pinna with parotid and temporo-mandibular infiltration. After surgical resection, the patient underwent a two staged reconstructive surgery. This was followed later on with radiotherapy and chemotherapy. The evolution was favourable for our patient during an 18 months follow-up. This case report underlines the importance of both curative and reconstructive surgery in successfully treating locally advanced tumors of the temporal bone.
Collapse
|
7
|
Nikolaenko SA, Khalapyan AA, Ilchenko OA, Shapiro LA. [Application of a universal system of epitesis fixation in the rehabilitation of patients with maxillofacial defects]. STOMATOLOGIIA 2022; 101:36-41. [PMID: 35362701 DOI: 10.17116/stomat202210102136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The aim of the study was the creation of a universal epithesis fixation system that increases the reliability of its functioning in prosthetics of patients with maxillofacial defects of various genesis. MATERIAL AND METHODS After the surgical preparation of patients, in accordance with the indications of the underlying disease, epithesis was made from rigid silicone elastomers using CAD/CAM technologies. For the production of attachments, the VT1-0 titanium alloy common in medicine was used. RESULTS A universal epithesis fixation system was used for prosthetics of various parts of the patient's face. Depending on the clinical situation and the size of the prosthetics area, an intermediate lattice plate (mesostructure) of the appropriate size and configuration was selected. Two types of attachments were used to fix epithets: magnetic with a counterpart and non-magnetic mushroom-shaped. The universal epithesis attachment system is distinguished by the possibility of using each hole of the lattice, both for attaching it to the bone structure and for installing attachments, which makes it easy to fix the lattice to residual bone fragments and center the position of the transition elements and attachments depending on the aesthetic and functional needs of the structure in whole. CONCLUSION The success of prosthetics largely depends on the epithesis attachment system. The proposed universal epithesis fixation system allows its use in various clinical situations and also reduces the cost of prosthetics for patients with maxillofacial defects.
Collapse
Affiliation(s)
- S A Nikolaenko
- Clinic of Professor Nikolayenko, Krasnoyarsk, Russia
- Federal Medical Production Center «Epitetica», Krasnoyarsk, Russia
- Center of Additional Professional Education «Professorship practice», Krasnoyarsk, Russia
| | - A A Khalapyan
- Clinic of Professor Nikolayenko, Krasnoyarsk, Russia
- Federal Medical Production Center «Epitetica», Krasnoyarsk, Russia
| | - O A Ilchenko
- Clinic of Professor Nikolayenko, Krasnoyarsk, Russia
- Federal Medical Production Center «Epitetica», Krasnoyarsk, Russia
- Center of Additional Professional Education «Professorship practice», Krasnoyarsk, Russia
| | - L A Shapiro
- Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia
| |
Collapse
|
8
|
Abstract
ABSTRACT Deformity and tissue loss involving the craniomaxillofacial region occurs frequently as a result of trauma, oncologic resection, or a congenital malformation. In order to maximize the patient's quality of life, reconstruction of the craniomaxillofacial skeleton must seek to restore aesthetics as well as function. Advances in diagnostic technology, surgical technique, instrumentation, and innovative biomaterials used have transformed the way reconstructive surgeons approach their patients' needs. From the advent of alloplastic reconstruction, surgeons have sought the ideal material for use in craniomaxillofacial surgery. Substances such as metals, ceramics, glasses, and more recently resorbable polymers and bioactive materials have all been utilized.While autologous bone has remained widely-favored and the gold standard, synthetic alternatives remain a necessity when autologous reconstruction is not readily available. Today, alloplastic material, autografting via microvascular tissue transfer, hormone and growth factor-induced bone formation, and computer-aided design and manufacturing of biocompatible implants represent only a fraction of a wide range of options used in the reconstruction of the craniomaxillofacial skeleton. We present a brief review of the materials used in the repair of deformities of the craniomaxillofacial skeleton as well as a look into the potential future direction of the field.
Collapse
|
9
|
Martel A, Baillif S, Nahon-Esteve S, Gastaud L, Bertolotto C, Lassalle S, Lagier J, Hamedani M, Poissonnet G. Orbital exenteration: an updated review with perspectives. Surv Ophthalmol 2021; 66:856-876. [PMID: 33524457 DOI: 10.1016/j.survophthal.2021.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 01/15/2023]
Abstract
Orbital exenteration is a radical and disfiguring surgery mainly performed in specialized tertiary care centers. Orbital exenteration has long been considered the treatment of choice for managing periocular tumors invading the orbit or primary orbital malignancies. Over the past decades, attention has been directed toward reducing the perioperative morbidity by developing new surgical devices and new strategies and promoting cosmetic rehabilitation by providing adequate facial prostheses. Despite these advances, several studies have questioned the role of orbital exenteration in improving overall survival. The last decade has been marked by the emergence of a new paradigm: the "eye-sparing" strategies based on conservative surgery with or without adjuvant radiotherapy and/or targeted therapies and immunotherapies. We summarize the data on orbital exenteration, including epidemiology, etiologies, use of surgical ablative and reconstructive techniques, complications, outcomes, and the related controversies.
Collapse
Affiliation(s)
- Arnaud Martel
- Université Côte d'Azur, Ophthalmology department, Centre Hospitalier Universitaire de Nice, Nice, France.
| | - Stephanie Baillif
- Université Côte d'Azur, Ophthalmology department, University Hospital of Nice, Nice, France
| | - Sacha Nahon-Esteve
- Université Côte d'Azur, Ophthalmology department, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Lauris Gastaud
- Oncology department, Antoine Lacassagne Cancer Centre, Nice, France
| | | | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology and Biobank BB-0033-00025, Nice, France
| | - Jacques Lagier
- Université Côte d'Azur, Ophthalmology department, University Hospital of Nice, Nice, France
| | - Mehrad Hamedani
- Oculoplastic department, Jules Gonin Eye hospital, Lausanne, Switzerland
| | - Gilles Poissonnet
- Cervico-facial department, Institut Universitaire de la Face et du Cou, Nice, France
| |
Collapse
|
10
|
De M, Mishra J, Sahu S, Arora R, Raghani M, Nagarkar N. Management of a late presentation of bear mauling with a complex maxillofacial defect in a tertiary care hospital - A case report. Ann Maxillofac Surg 2021; 11:359-362. [PMID: 35265517 PMCID: PMC8848690 DOI: 10.4103/ams.ams_218_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/29/2021] [Accepted: 12/06/2021] [Indexed: 11/04/2022] Open
Abstract
Rationale: Patient Concerns: Diagnosis and Treatment: Outcome: Take-away Lessons:
Collapse
|
11
|
Negreiros WAD, Teixeira RR, Peixoto RF, Regis RR. The challenge of managing oral maxillofacial rehabilitation with quality and cost-benefit. J Prosthet Dent 2020; 127:508-514. [PMID: 33303193 DOI: 10.1016/j.prosdent.2020.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 10/22/2022]
Abstract
Although orofacial cancer leads to substantial functional, esthetic, and psychosocial deficits for patients, reconstructive plastic surgeries may not be indicated for large facial defects. The high costs of prosthetic oral maxillofacial rehabilitation may hamper such treatment, which commonly involves virtual planning, craniofacial implants, and computer-aided design and computer-aided manufactured prostheses. This report shows the treatment of 2 patients with large facial defects from surgical resection of cancerous tissue who were rehabilitated with implant-supported bar-clip overdentures and facial prostheses fabricated by using low-cost straightforward methods.
Collapse
Affiliation(s)
- Wagner Araujo de Negreiros
- Associate Professor, Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
| | - Raiza Ricarte Teixeira
- Predoctoral student, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
| | - Raniel Fernandes Peixoto
- Adjunct Professor, Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil.
| | - Rômulo Rocha Regis
- Adjunct Professor, Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
| |
Collapse
|
12
|
Powell SK, Cruz RLJ, Ross MT, Woodruff MA. Past, Present, and Future of Soft-Tissue Prosthetics: Advanced Polymers and Advanced Manufacturing. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2020; 32:e2001122. [PMID: 32909302 DOI: 10.1002/adma.202001122] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/23/2020] [Indexed: 06/11/2023]
Abstract
Millions of people worldwide experience disfigurement due to cancers, congenital defects, or trauma, leading to significant psychological, social, and economic disadvantage. Prosthetics aim to reduce their suffering by restoring aesthetics and function using synthetic materials that mimic the characteristics of native tissue. In the 1900s, natural materials used for thousands of years in prosthetics were replaced by synthetic polymers bringing about significant improvements in fabrication and greater realism and utility. These traditional methods have now been disrupted by the advanced manufacturing revolution, radically changing the materials, methods, and nature of prosthetics. In this report, traditional synthetic polymers and advanced prosthetic materials and manufacturing techniques are discussed, including a focus on prosthetic material degradation. New manufacturing approaches and future technological developments are also discussed in the context of specific tissues requiring aesthetic restoration, such as ear, nose, face, eye, breast, and hand. As advanced manufacturing moves from research into clinical practice, prosthetics can begin new age to significantly improve the quality of life for those suffering tissue loss or disfigurement.
Collapse
Affiliation(s)
- Sean K Powell
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
| | - Rena L J Cruz
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
| | - Maureen T Ross
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
| | - Maria A Woodruff
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
| |
Collapse
|
13
|
Kupcha AC, Mawn LA. Use of Dermaflage ®, a silicone-based skin camouflage product, for treatment of medial canthal fistula. Orbit 2019; 39:61-63. [PMID: 31181962 DOI: 10.1080/01676830.2019.1579845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Medial canthal fistulas present a therapeutic challenge, given that the risk factors for development of this and similar complications also contribute to their difficulty to treat. Following surgical, chemotherapy and radiation treatment of a poorly differentiated sinonasal carcinoma, a 61 year old man failed internal and external rotational flap repair and declined further operative procedures; he was satisfied with a novel conservative treatment. This report describes use of Dermaflage®, a silicone-based skin camouflage and topical cutaneous filler product, to both resolve the symptoms of tearing and discharge through the fistula and mask the defect from the casual observer.
Collapse
Affiliation(s)
- Anna C Kupcha
- Department of Ophthalmology and Visual Sciences, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Louise A Mawn
- Department of Ophthalmology and Visual Sciences, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
14
|
Vincent A, Kohlert S, Kadakia S, Sawhney R, Ducic Y. Prosthetic Reconstruction of Orbital Defects. Semin Plast Surg 2019; 33:132-137. [PMID: 31037051 DOI: 10.1055/s-0039-1685479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Orbital and craniomaxillofacial defects, in general, are best approached preoperatively by a multidisciplinary team with a clear reconstructive plan in place. Orbital defects result from a myriad of underlying diseases and injuries, and reconstruction after orbital evisceration, enucleation, or exenteration can pose a challenge to the reconstructive team. Reconstruction of orbital injuries with orbital implants and prostheses can lead to acceptable aesthetic outcomes, and the reconstructive surgeon should be familiar with current orbital implants and prostheses. Herein, the authors review terminology and classifications of orbital defects, different types of orbital implants, advantages and disadvantages of different orbital implant reconstructive options, types of orbital prostheses, and pros and cons of different prosthetic options.
Collapse
Affiliation(s)
- Aurora Vincent
- Otolaryngology, Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington
| | - Scott Kohlert
- Department of Otolaryngology - Head and Neck Surgery, University of Ottawa, Canada
| | - Sameep Kadakia
- Department of Plastic and Reconstructive Surgery, Wright State University, Dayton, Ohio
| | - Raja Sawhney
- Facial Plastics, University of Gainesville, Florida
| | - Yadranko Ducic
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
| |
Collapse
|
15
|
Zopf DA, Flanagan CL, Mitsak AG, Brennan JR, Hollister SJ. Pore architecture effects on chondrogenic potential of patient-specific 3-dimensionally printed porous tissue bioscaffolds for auricular tissue engineering. Int J Pediatr Otorhinolaryngol 2018; 114:170-174. [PMID: 30262359 PMCID: PMC6196359 DOI: 10.1016/j.ijporl.2018.07.033] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aims to determine the effect of auricular scaffold microarchitecture on chondrogenic potential in an in vivo animal model. METHODS DICOM computed tomography (CT) images of a human auricle were segmented to create an external anatomic envelope. Image-based design was used to generate 1) orthogonally interconnected spherical pores and 2) randomly interspersed pores, and each were repeated in three dimensions to fill the external auricular envelope. These auricular scaffolds were then 3D printed by laser sintering poly-l-caprolactone, seeded with primary porcine auricular chondrocytes in a hyaluronic acid/collagen hydrogel and cultured in a pro-chondrogenic medium. The auricular scaffolds were then implanted subcutaneously in rats and explanted after 4 weeks for analysis with Safranin O and Hematoxylin and Eosin staining. RESULTS Auricular constructs with two micropore architectures were rapidly manufactured with high fidelity anatomic appearance. Subcutaneous implantation of the scaffolds resulted in excellent external appearance of both anterior and posterior auricular surfaces. Analysis on explantation showed that the defined, spherical micropore architecture yielded histologic evidence of more robust chondrogenic tissue formation as demonstrated by Safranin O and Hematoxylin and Eosin staining. CONCLUSIONS Image-based computer-aided design and 3D printing offers an exciting new avenue for the tissue-engineered auricle. In early pilot work, creation of spherical micropores within the scaffold architecture appears to impart greater chondrogenicity of the bioscaffold. This advantage could be related to differences in permeability allowing greater cell migration and nutrient flow, differences in surface area allowing different cell aggregation, or a combination of both factors. The ability to design an anatomically correct scaffold that maintains its structural integrity while also promoting auricular cartilage growth represents an important step towards clinical applicability of this new technology.
Collapse
Affiliation(s)
- David A Zopf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, 1540 E Hospital Dr., Ann Arbor, MI, 48109, USA.
| | - Colleen L Flanagan
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd., Ann Arbor, MI, 48109, USA
| | - Anna G Mitsak
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd., Ann Arbor, MI, 48109, USA
| | - Julia R Brennan
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, 1540 E Hospital Dr., Ann Arbor, MI, 48109, USA
| | - Scott J Hollister
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive, Atlanta, GA, 30332, USA
| |
Collapse
|