Surgical Mesh an Eye Support Post Total Maxillectomy: A Case Study and Review of Literature
Authors/Creators
- 1. Associate Professor and Head, Department of ENT & HNS, RUHS College of Medical Sciences, Jaipur
- 2. Senior Residents, Department of ENT & HNS, RUHS College of Medical Sciences, Jaipur
- 3. Professor, Department of ENT & HNS, RUHS College of Medical Sciences, Jaipur
- 4. Junior Specialist, Department of ENT & HNS, RUHS College of Medical Sciences, Jaipur
Description
Introduction: Post Maxillectomy reconstruction is more commonly done by prosthesis. Surgical management by microvascular grafting or autogenous tissue is more agreeable but is not always possible. Also surgical reconstruction is expensive, not readily available and if failure occurs then prosthetic reconstruction becomes a better option. Given the irregular cavity created post Maxillectomy and the shape of the orbit, meshes provide a reliable alternate to bone and help in preventing enophthalmos, diplopia, visual acquity defects, restricted eye movements etc. Material and Methods: After complete removal of the maxilla and achievement of hemostasis, the mesh was cut to adequate shape. The mesh was then inserted in the defect to form a sling and sutured to soft tissue around zygoma and attached soft tissue laterally and to nasal septal mucosa or turbinates medially using Vicryl 3-0 sutures. Adequate support was achieved for the orbital contents in a hammock like fashion. Incision was closed and the cavity given time to heal and approximately 3-4 weeks after surgery a fabricated obturator is used for rest of the cavity. Conclusion: Prolene propylene mesh though a primary material in abdominal surgery can be used to as an effective Post Total Maxillectomy Orbital support both in case of obturator use or in free flap repair.
Abstract (English)
Introduction: Post Maxillectomy reconstruction is more commonly done by prosthesis. Surgical management by microvascular grafting or autogenous tissue is more agreeable but is not always possible. Also surgical reconstruction is expensive, not readily available and if failure occurs then prosthetic reconstruction becomes a better option. Given the irregular cavity created post Maxillectomy and the shape of the orbit, meshes provide a reliable alternate to bone and help in preventing enophthalmos, diplopia, visual acquity defects, restricted eye movements etc. Material and Methods: After complete removal of the maxilla and achievement of hemostasis, the mesh was cut to adequate shape. The mesh was then inserted in the defect to form a sling and sutured to soft tissue around zygoma and attached soft tissue laterally and to nasal septal mucosa or turbinates medially using Vicryl 3-0 sutures. Adequate support was achieved for the orbital contents in a hammock like fashion. Incision was closed and the cavity given time to heal and approximately 3-4 weeks after surgery a fabricated obturator is used for rest of the cavity. Conclusion: Prolene propylene mesh though a primary material in abdominal surgery can be used to as an effective Post Total Maxillectomy Orbital support both in case of obturator use or in free flap repair.
Files
IJPCR,Vol15,Issue6,Article161.pdf
Files
(1.7 MB)
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Additional details
Dates
- Accepted
-
2023-05-15
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue6,Article161.pdf
- Development Status
- Active
References
- 1. Aramany MA. Basic principles of obturator design for partially edentulous patients. Part I: Classification. J Prosthet Dent. 1978;40:554-7 2. Roumananas ED, Nishimura RD, Davis BK, Beumer J III.Clinical evaluation ofimplants retaining edentulous maxillary obturator prostheses.J Prosthet Dent. 1997; 77:184-9. 3. Villarreal PM, Florencio M, Morillo AJ, et al. Porous polyethylene implants in orbital floor reconstruction. Plast Reconstr Surg. 2002; 109:877–885. 4. Al-Sukhun J, Lindqvist C. A comparative study of 2 implants used to repair inferior orbital wall bony defects: autogenous bone graft versus bioresorbable poly-L/DL-Lactide Plate. J Oral Maxillofac Surg. 2006; 64: 1038 –1048. 5. Chowdhury K, Krause GE. Selection of materials for orbital floor reconstruction. Arch Otolaryngol Head Neck Surg. 1998;124:1398–1401.