Osseointegrated implant applications in cosmetic and functional skull base rehabilitation

Autor: Matthew L. Kircher, Brent J. Benscoter, James J. Jaber, Sam J. Marzo, John P. Leonetti
Rok vydání: 2012
Předmět:
Zdroj: Skull base : official journal of North American Skull Base Society ... [et al.]. 21(5)
ISSN: 1532-0065
Popis: Osseointegration as a method of securing dental implants to the facial skeleton has existed in the literature since the late 1960s.1 The bone-anchored hearing aid was the first application of a bone-anchored implant outside the oral cavity. Developed by Dr. Tjellstrom in Sweden in 1977, the device enables sound energy to be transmitted directly to the skull base via an attachable vibrator, and thus began a new era in hearing rehabilitation. Bone-anchored hearing aids have superior sound transmission and avoid painful pressure on the skin associated with traditional bone-conduction hearing aids.2 In addition, the bone-anchored hearing aid is an excellent option for those with single-sided hearing loss in which a traditional hearing aid is not an option, (i.e., postradical temporal bone resection or canal oversewn procedure). Two years after the implantation of the bone-anchored hearing aid, osseointegrated abutments were used to anchor prostheses for the ear, nose, orbit, and midface in the rehabilitation of patients with craniofacial defects from cancer surgery, congenital malformations, and traumatic amputations.3 Hairstyling can mask some skull base deformities but is often inadequate. Prostheses glued directly to the skin are useful in many patients, but mechanical and chemical irritation resulting from adhesives and solvents can result in skin and mucosal irritation.4 Orbital defects can be especially troubling for patients, and are often difficult to hide. Autogenous reconstruction is virtually impossible, masks are ineffective, and prostheses anchored on glasses are cumbersome. With significant improvements in prosthetic materials and implantation devices, prostheses attached via implanted abutments are now better tolerated, offer improved quality of life, and are often the best option.4,5 Osseointegrated implant application has changed many of the fundamentals of rehabilitation for those specialties working outside the oral cavity. The affected specialties include otolaryngology—head and neck surgery, maxillofacial surgery, and plastic surgery, all of which have reported excellent outcomes. In reverse order of technology, the U.S. Food and Drug Administration approved anchoring craniofacial prostheses on osseointegrated implants in 1985, and later approved the use of implants to anchor hearing aids in adults in 1995.6 The objective of this study was to evaluate and discuss the applications, techniques, outcomes, and complications in patients that underwent osseointegrated implantation for skull base rehabilitation at a tertiary care facility. Emphasis was placed on patients receiving osseointegrated implants for cosmetic reasons with or without functional rehabilitation utilizing osseointegrated bone-conduction hearing aids.
Databáze: OpenAIRE
Externí odkaz: