Repairing a Facial Cleft by Polyether–Ether–Ketone Implant Combined With Titanium Mesh

Abstract

The Tessier Number 4 cleft is one of the rarest, most complex craniofacial anomalies that presents difficulties in surgical treatment. In this article, we report a case of simultaneous facial depression, eye displacement, and medial canthus deformity. In this case, the maxillary bony defect was reconstructed using computer-assisted design computer-assisted manufacturing (CAD-CAM) polyether-ether-ketone (PEEK) material, and the orbital floor defect was repaired with AO prefabricated titanium mesh. Additionally, the medial canthus was modified with canthopexy and a single Z-plasty flap. Owing to its relative rarity and varied clinical presentations, no definitive operative methods have been accepted for Tessier No. 4 facial cleft. This study presents the combination of CAD-CAM manufactured PEEK material and titanium mesh as an alternative approach for reconstructing the bony defect of Tessier No. 4 facial clefts.

Predictors for Surgeries With the Endoscope-Navigation System for Traumatic Optic Neuropathy and its Clinical Assessment

“…22 Seemingly, 72.5% even 51.4% improvement rate in adult patients is encouraging, advocating that the ENS for TON surgery met the advantages of symmetrical matching of images, visibility of tissues, and real-time warning of important structures. 7,11 With those advantages, precise locating, complete decompression, and low complication rate were achieved (none of our patients met carotid leak, data not shown).…”

“…The endoscopenavigation system (ENS) is a branch of computer-assisted surgery system designed for orbital surgery and has been developed to enhance the safety of TON surgery, reduce the operative time for easy surgery training and implementation. 7 The surgical risks like cerebral fluid leak, internal carotid eruption, and aberrance (sphenoid sinus malformation, internal carotid ectopia, etc) in most of the cases prevented both doctors and patients to undergo surgeries, especially among the TON patients whose morphological changes of the optic canal are usually not definitely observed. 8 Time interval from trauma to medicine or surgery is believed to be an important index for outcomes.…”

“…Among the researchers who advocated surgical ways, Di Somma et al 5 showed advantages with regards to a traditional transcranial approach by larger explosion proportion of optic nerve, whereas Mesquita Filho et al 6 revealed that endoscopic transethmosphenoid optic canal decompression deserves more attention due to its minimal invasive nature and almost the same anatomical changes in surgery compared with the traditional way. The endoscope-navigation system (ENS) is a branch of computer-assisted surgery system designed for orbital surgery and has been developed to enhance the safety of TON surgery, reduce the operative time for easy surgery training and implementation 7 . The surgical risks like cerebral fluid leak, internal carotid eruption, and aberrance (sphenoid sinus malformation, internal carotid ectopia, etc) in most of the cases prevented both doctors and patients to undergo surgeries, especially among the TON patients whose morphological changes of the optic canal are usually not definitely observed 8 …”

Strategies to improve bioactive and antibacterial properties of polyetheretherketone (PEEK) for use as orthopedic implants

“…At present, PEEK implants are increasingly used as spinal cages [ 4 ], skull or maxillofacial defect repair implants [ 5 , 6 ], dental implants [ 7 ], joint replacements [ 8 ], fixation devices [ 9 ], and so on. PEEK cages are widely used in spinal fusion due to their radiolucency and low elastic modulus [ [10] , [11] , [12] ].…”