Customized skull base-temporomandibular joint combined prosthesis with 3D-printing fabrication for craniomaxillofacial reconstruction: a preliminary study.

Abstract

Temporomandibular joint (TMJ) lesions, when large and extensive, will often involve skull base destruction and result in extensive resections, requiring a challenging reconstruction. This study introduces a special type of craniomaxillofacial prosthesis for massive combined skull base-TMJ lesions. Patients who presented with combined skull base-TMJ lesions were recruited. Enhanced computed tomography (CT) data were obtained for all patients and transformed into three-dimensional (3D) reconstruction models. The combined skull base-TMJ prosthesis was designed and fabricated with a customized principle by 3D-printing technology. Clinical follow-up and radiographic evaluations were performed to assess the feasibility of the combined prosthesis in clinical application. A series of five consecutive patients were included in this study. No severe complications occurred after surgery. Based on a mean follow-up period of 13.8 months, the preliminary results suggest that the combined prosthesis has a positive impact on clinical outcomes: there was a mean 75.0% reduction in pain, 55.6% improvement in diet, 54.5% improvement in mandibular function, and 33.6% increase in mouth opening, with significant differences when compared with the preoperative state (all P<0.05). This study suggests that the combined prosthesis represents a safe and reliable implantable reconstruction method for combined skull base-TMJ lesions.