How 3D titanium implant could improve orbital reconstruction after maxillectomy

Summary Surgical treatment of maxillary tumours often consists of an open sub-total or total maxillectomy with a subsequent significant defect. Reconstruction is therefore a major challenge for head and neck surgeons. Along with 3D printing development, titanium prebent implants have been created for orbital wall and floor reconstruction. The aim of this study was to evaluate the postoperative tolerance of these implants in patients who had undergone this procedure in our department. Implant tolerance was the primary endpoint, evaluated by whether or not surgery was required for infection or extrusion 6 months after the procedure. The secondary endpoints were satisfactory functional and aesthetic characteristics of the reconstruction as well as quality of life. Eleven patients underwent a maxillectomy with orbital floor resection for tumours and reconstruction using the titanium PorousiTi® (Materialise®, Leuven, Belgium) implant beginning in 2013 in Lariboisiere Hospital, Paris. The mean follow-up time was 17 months (range, 6–34). During the follow-up period, two patients (n=2/11; 18.2%) were operated again for implant extrusion and exposure through the skin 1 month later or during their radiotherapy course. During the follow-up period, no postoperative infection occurred in any of the patients. In our experience, the implant was well-tolerated with few postoperative complications and satisfactory aesthetic and functional results.