J.L. del Castillo

Polyetheretherketone custom-made implants for craniofacial defects: Report of 14 cases and review of the literature

BACKGROUND Craniofacial defects tend to carry functional and esthetic consequences for the patient. The complex shapes in this region make such reconstructions a challenging procedure and the most suitable material to be used remains controversial. METHODS We report a series of 14 patients whose craniofacial defects were reconstructed using a computer designed PEEK-PSI (Polyetheretherketone- Patient Specific Implant). We analyzed the complications and outcomes of PEEK custom-made implants and compared our results with those of other case series reported in the current literature. RESULTS Fourteen patients underwent craniofacial reconstruction using a PEEK-PSI. Three cases involved a one-step primary reconstruction and the rest of cases underwent a delayed reconstruction. Two cases (14.3 %) presented infection and only in one case was the implant definitively removed. Esthetic results were considered to be highly satisfactory. CONCLUSION With CAD-CAM techniques, it is possible to prefabricate an individual implant. The ideal material for reconstructing maxillofacial defects does not exist, but PEEK has demonstrated good outcomes. When autologous bone is not available or, in selected cases with large or complex defects in the maxillofacial area, PEEK is one of the best options to reconstruct these defects. However, further studies are needed to determine the long-term results.

Reconstrucción craneal mediante malla de titanio y cemento de apatita carbonatada

Resumen Presentamos el caso de un paciente de 45 anos de edad, que tras ser intervenido en dos ocasiones de un meningioma gigante del ala mayor del esfenoides mediante una craneotomia pterional con ampliacion orbito-zigomatica, sufre un proceso infeccioso en el colgajo oseo que obliga a la retirada del mismo. Se decidio realizar la reparacion del defecto craneal mediante el uso combinado de una malla de titanio y cemento de hidroxiapatita (Norian®), sumando asi la resistencia del titanio al excelente resultado estetico en cuanto a contorno y volumen que se puede lograr con el cemento de hidroxiapatita.

Fístula arteriovenosa postraumática: tratamiento endovascular. Revisión de la literatura y presentación de un caso clínico

Traumatic arteriovenous fistulas of the head and neck region are uncommon. The majority are due to penetration of blunt injury. We describe a successful endovascular treatment of a posttraumatic fistula between the left maxillary artery and the external jugular vein due to a penetration injury. This case and a review of the literature illustrate the causes, manifestations, image studies and treatment for a posttraumatic fistula between the maxillary artery and the external jugular vein. This case demonstrate the utility of endovascular treatment of head and neck injuries complications.

La enfermedad de Kimura: comunicación de un caso en un varón caucásico y revisión de la literatura

espanolLa enfermedad de Kimura es un trastorno inflamatorio que afecta principalmente a sujetos de origen asiatico. Se manifiesta por la existencia de masas de tejido subcutaneo y subplatismal generalmente en la cabeza y el cuello. Suele acompanarse de linadenopatias, y aumento de los niveles de eosinofilos e IgE en sangre periferica. Comunicamos un caso de enfermedad de Kimura, descubierto en un varon caucasiano, tras una biopsia excisional de una masa cervical. EnglishKimura disease is a chronic inflammatory disorder mainly involving Asians. It often presents as soft-tissue nodes or lymphadenopathy of the head and neck. Commonly associated with increased levels of eosinophils and IgE in peripheral blood. We report a case of Kimura disease in a Caucasian, diagnosed after lymph node and submaxillary gland removal.