AB095. SOH23ABS_085. The zygomatic implant perforated (ZIP) flaps and zygomatic implant-based rehabilitation for patients with maxillary and mid-facial oncology defects
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AB095. SOH23ABS_085. The zygomatic implant perforated (ZIP) flaps and zygomatic implant-based rehabilitation for patients with maxillary and mid-facial oncology defects

Brian Martin1, Edward Cotter2, James Paul O’Neill3, Conor Bowe1, John O’Connell1

1National Maxillofacial Unit, St. James’s Hospital, Dublin, Ireland; 2Department of Dental Oncology/Maxillofacial Prosthodontics, Hermitage Clinic, Dublin, Ireland; 3Department of Otolaryngology/Head & Neck Surgery, Beaumont Hospital, Dublin, Ireland

Background: The management of patients with a maxillary tumour is complex, especially reconstruction and rehabilitation. The techniques for closure or obturation of any oro-antral/nasal communication are well described. What is less well described is the effective and timely restoration of facial form and dentition, ideally prior to commencement of radiotherapy. The zygomatic implant perforated (ZIP) flap technique and zygomatic implant supported prosthesis provides immediate reconstruction and rapid dental rehabilitation. Herein, we describe their use in 4 consecutive cases of midface/maxillary oncologic ablative defects.

Methods: Patients who underwent ZIP flap/zygomatic implant reconstruction between January 2022 and November 2022 are described. The following variables were recorded: age, sex, pathology, ablative defect, number and location of zygomatic implants, median time to placement of prosthesis, and free flap outcomes.

Results: Four patients (3 males, 1 female) were included the study. The mean age at surgery was 68 years (range, 62 to 76 years). The pathologies were as follows: 3 squamous cell carcinoma and 1 olfactory neuroblastoma. Two patients had a total maxillectomy; 2 had an extended hemi-maxillectomy. Two patients had a ZIP flap including a radial forearm free flap, and 2 had a zygomatic implant supported obturator prosthesis. The total number of zygomatic implants placed was 14. All had good primary stability. The median time to prosthesis fit was 22 days. All patients underwent adjuvant radiotherapy.

Conclusions: The ZIP flap and zygomatic implant retained prosthesis techniques provide and safe and reliable method for reconstruction and rehabilitation of patients with post ablative mid-face defects.

Keywords: Dental rehabilitation; free-flap reconstruction; maxillectomy; midface defects; zygomatic implants

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-23-ab095
Cite this abstract as: Martin B, Cotter E, O’Neill JP, Bowe C, O’Connell J. AB095. SOH23ABS_085. The zygomatic implant perforated (ZIP) flaps and zygomatic implant-based rehabilitation for patients with maxillary and mid-facial oncology defects. Mesentery Peritoneum 2023;7:AB095.

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