MODERN APPROACHES TO THE ORBITAL WALL RECONSTRUCTION WITH TITANIUM NICKELIDE IMPLANTS IN PATIENTS WITH NASAL CAVITY AND PARANASAL SINUS CANCER

Background. The majority of tumors of the nasal cavity and paranasal sinus are diagnosed at an advanced stage, requiring invasive and mutilating surgery, and therefore, the reconstruction of post-surgical craniofacial bone defects using various implants is necessary.

Purpose of the study: to evaluate the effectiveness of the use of the thin-profile implants made of titanium nickelide in the surgical treatment of nasal cavity and paranasal sinus cancers.

Material and Methods. From 2002 to 2020, a total of 60 patients with stage Т3–4n0–1M0 nasal cavity and paranasal sinus cancer were treated at the Cancer Research institute (tomsk). All patients received radiation therapy followed by surgery with reconstruction of bone structures of the subcranial region and orbital walls. In the study group (n=30), the orbital walls were restored with individual thin-profile shape memory titanium nickelide implants. In the control group (n=30), typical porous and tissue titanium nickelide implants were used. They required adjustment during surgery and complicated reparative processes in the postoperative period due to their thickness. Tissue implants did not allow accurate restoration of the orbital walls due to their structure.

Results. Surgical rehabilitation with orbital wall reconstruction using thin-profile titanium nickelide implants makes it possible to shorten the duration of surgery and improve the precision of surgical repair. Features of the architectonics of implants do not interfere with the growth of tissues of the recipient zone, thus preventing the development of inflammation in the implantation site. The technique allows adequate restoration of the natural position and function of the eye.

1. Minkin A.U. Comprehensive diagnosis and treatment of precancerous diseases and malignant tumors of the upper jaw, nasal cavity and paranasal sinuses. Arkhangelsk, 2011. 255 p. (in Russian).

2. Novikov V.A., Shtin V.I., Frolova I.G., Trukhacheva N.G., Shilova O.G., Nikitchuk A.V., Kucherova T.Ya., Molchanov N.A. Novel approaches to treatment and rehabilitation of patients with cancer of nasal accessory sinuses using Titanium Nickelid and computer-bases tecnologies. Siberian Journal of Oncology. 2007; 2: 63–68. (in Russian).

3. Medvedev Yu.A., Shamanaeva L.S., Petruk P.S., Yang Sin, Solovieva A.A. Nickelid titanium mesh for orbital floor reconstruction. Stomatology. 2014; 3: 35–38. (in Russian).

4. Medvedev Y.A., Shamanayeva L.S., Shamanayev S.V., Polyakov K.A.1, Petruk P.S. Endoprosthesis of lower orbital wall. Endoprosthesis of lower orbital wall. Head and Neck. 2017; 1: 18–22. (in Russian).

5. Bhattacharyya N. Survival and staging characteristics for nonsquamous cell malignancies of the maxillary sinus. Arch Otolaryngol Head Neck Surg. 2003 Mar; 129(3): 334–7. doi: 10.1001/archotol.129.3.334.

6. Hausamen J.E. The scientific development of maxillofacial surgery in the 20-th century and an outlook into the future. J. Craniomaxillofacial. Surg. 2001; 29(1): 2–21.

7. Jones N.F., Hardesty R.A., Swartz W.M., Ramasastry S.S., Heckler F.R., Newton E.D. Extensive and complex defects of the scalp, middle third of the face, and palate: the role of microsurgical reconstruction. Plast Reconstr Surg. 1988 Dec; 82(6): 937–52. doi: 10.1097/00006534- 198812000-00001.

8. Nishino H., Ichimura K., Tanaka H., Ishikawa K., Abe K., Fujisawa Y., Shinozaki T. Results of orbital preservation for advanced malignant maxillary sinus tumors. Laryngoscope. 2003 Jun; 113(6): 1064–9. doi: 10.1097/00005537-200306000-00028.

9. Paches A.I. Tumors of the head and neck. Moscow, 1997. 460 p. (in Russian).

10. Reshetov I.V., Kravtsov S.A., Matorin O.V., Polyakov A.P. Plastic surgery in the treatment of malignant tumors of the upper jaw and orbit using musculoskeletal flaps with the inclusion of the rib. Annals of Plastic, Reconstructive and Aesthetic Surgery. 1998; 3: 42–43. (in Russian)].

11. Kaercher T., Buchholz P., Kimmich F. Treatment of patients with keratoconjunctivitis sicca with Optive: results of a multicenter, open-label observational study in Germany. Clin Ophthalmol. 2009; 3: 33–9.

12. Konig F. Technick ausgedehnter oberkieforcarcinoma. Arch Klin Chir. 1900. 775 p.

13. Chebotarev S.Ya., Mirzayan G.R., Belov I.Yu., Primak N.A., Gulyaev D.A. Correction the skull base and midface defects after surgical treatment of the widespread cranio-maxillary tumors. Siberian Journal of Oncology. 2016; 15(4): 62–69. (in Russian).

14. Chuikov M., Matyakin E.G., Azizyan R.I., Akhundov A.A., Mudunov A.M., Podvyaznikov O., Fedotov N.N., Chuchkov M.V., Agapov V.V. Orthopedic rehabilitation of cancer patients with upper jaw defects. Modern Oncology. 2006; 8(3): 28–34. (in Russian).

15. Giri P.S., Paddy E.K., Garter L.S., Krishnan L., Smalley S.S., Evans R.G. Optimum management of advanced squamous cell carcinoma of the maxillary sinus. Int J Rad Oncol Biol Phys. 1990; 19: 242.

16. Andreev V.G., Baryshev V.V., Dementyev A.V. Single-stage functional reconstruction of lower wall of the orbit after maxillary tumor removal. Siberian Journal of Oncology. 2010; 4: 43–46. (in Russian).

17. Baryshev V.V., Andreev V.G. The method of single-stage reconstruction of lower wall of the orbit. Russian Otorhinolaryngology. 2011; 2(51): 38–40. (in Russian).

18. Belchenko V.A., Rybalchenko G.N., Baraniuk I.S. Clinical and anatomical rationale for transanthral approach in orbital floor fractures. Part II. Stomatology. 2014; 93(3): 23–27. (in Russian).

19. Bernadsky Yu.I. Traumatology and reconstructive surgery of the cranio-maxillofacial area. Moscow, 1999. 456 p. (in Russian).

20. Grusha O.V., Grusha Ya.O. 500 plastic of the orbit: an analysis of complications. Bulletin of Ophthalmology. 2006; 1: 22–24. (in Russian).

21. Rootman J., Stewart P., Goldberg R.A. Orbital surgery: A conceptual approach. Plymouth: Lippencott-Raven Publ., 1996. 394 p.

22. Medvedev Yu.A., Petruk P.S., Shamanaeva L.S., Volkova V.A., Davidov AR. The use of Foley catheter in reconstructive procedures involving the middle third of the facial skeleton. Stomatology. 2016; 95(3): 31–37. (in Russian). doi: 10.17116/stomat201695331-37

23. Joseph J.M., Glavas I.P. Orbital fractures: a review. Clin Ophthalmol. 2011 Jan 12; 5: 95–100. doi: 10.2147/OPTH.S14972.

24. Filatova I.A., Tishkova A.P., Beraia M.Z., Poliakova L.Ia., Tkhelidze N.R. Computed tomography in diagnosing and determining treatment policy in patients with posttraumatic pathology of the eye and orbit. Bulletin of Ophthalmology. 2005. 6: 9–14. (in Russian).

25. Shtin V.I. A method of restoring the walls of the orbit after operations for locally advanced tumors of the nasal cavity and paranasal sinuses. Siberian Journal of Oncology. 2007; Suppl. 2: 130–131. (in Russian).

26. Marsh J.L., Vannier M.W., Stevens W.G., Warren J.O., Gayou D., Dye D.M. Computerized imaging for soft tissue and osseous reconstruction in the head and neck. Clin Plast Surg. 1985 Apr; 12(2): 279–91.

27. Shalumov A.Z., Levchenko O.V., Sharifullin F.A., Nasibullin A.M., Bulycheva E.G., Krylov V.V. X-ray computed tomography of maxillofacial injuries associated with traumatic brain injury. Neurosurgery. 2009; 4: 42-49. (in Russian).

28. Sokolov N.N. Immediate epithelialization of the oral cavity after resection of the upper jaw. New Surgery Archive. 1969; 43: 321–327. (in Russian).

29. Choynzonov E.L., Balatskaya E.L., Kitsmanyuk Z.D., Dubskiy S.V. Rehabilitation of patients with head and neck tumors. Tomsk, 2003. 296 p. (in Russian).