Zygomatic implants for supporting nasal epitheses in large carcinological rhinectomies: case reports

Two patients aged 55 and 62 underwent total rhinectomy followed by radiotherapy for the treatment of nasal squamous cell carcinoma. Initially, a conventional nasal epithesis was fitted, but was not tolerated due to allergic reactions to skin adhesives and stability issues caused by the weight of spectacles on the epitheses. A second surgical procedure was therefore performed to place two zygomatic implants, anchored at a distance from the irradiated bone, providing additional retentive support via a bar-and-clip connection. Post-implant follow-up revealed early failure of one of the two implants in the first patient, necessitating its replacement. A two-year follow-up confirmed the stability of all implants, with a notable improvement in prosthetic retention and patient comfort, alongside minimal complaints. This two-case report describes an innovative approach relying exclusively on the use of zygomatic implants to support a nasal prosthesis, a method still scarcely documented in the literature. It provides a detailed account of the surgical protocol followed and opens up promising prospects for the rehabilitation of post-oncological midfacial defects.