Patient-specific PEEK implants for immediate restoration of temporal fossa after maxillary reconstruction with temporalis muscle flap

Sherif Ali, Omniya Abdel Aziz, Mamdouh Ahmed, Sherif Ali, Omniya Abdel Aziz, Mamdouh Ahmed

Abstract

Background: Temporal hollowing is a common complication following the rotation of the temporalis muscle that leaves the patient with a cosmetic impairment. Several alloplastic materials have been used to reconstruct the donor site; however, these implants need meticulous adaptation to conform the periphery of the defect and restore the contour of the temporal area. The aim of this study was to assess the use of patient-specific polyetheretherketone (PEEK) temporal implants to prevent temporal hollowing following the use of full temporalis muscle flap for large maxillary defects reconstruction.

Methods: This was a prospective study conducted on eight patients with major maxillary defects indicating the need of reconstruction with full temporalis muscle flap or any lesion indicating major maxillary resection and immediate reconstruction with total temporalis muscle flap. For each patient, a patient-specific PEEK implant was fabricated using virtual planning and milled from PEEK blocks. In the surgical theater, the temporalis muscle was exposed, elevated, and transferred to the maxilla. After the temporalis muscle transfer, PEEK implants were fixed in place to prevent temporal hollowing.

Results: The surgical procedures were uneventful for all patients. The esthetic result was satisfactory with no post-operative complications except in one patient where seroma occurred after 2 weeks and resolved after serial aspiration.

Conclusion: Patient-specific PEEK implant appears to facilitate the surgical procedures eliminate several meticulous steps that are mainly based on the surgeon's experience.

Trial registration: Clinical trials registration: NCT05240963 .

Keywords: Computer-assisted surgery; Maxillofacial reconstruction; Patient-specific implants; Rapid prototyping; Temporal hollowing; Temporalis flap.

Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
The temporalis muscle virtually segmented and separated (green)
Fig. 2
Fig. 2
The muscle refined to create the final virtual temporal implant (red)
Fig. 3
Fig. 3
The virtual implant formed of four interlocking parts
Fig. 4
Fig. 4
The printed patient-specific PEEK implants
Fig. 5
Fig. 5
The temporalis muscle before elevation
Fig. 6
Fig. 6
The temporalis muscle after elevation and the PEEK implant parts initially seated in place
Fig. 7
Fig. 7
The PEEK implant fixed in position
Fig. 8
Fig. 8
Incisions sutured in layers
Fig. 9
Fig. 9
Photograph of the patient 4 weeks after the surgery

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