Partial nasal reconstruction with titanium mesh: report of five cases

Abstract

The nasal pyramid is frequently affected by nonmelanoma skin cancer. Sometimes the aggressiveness of tumours entails the extirpation of the mucosa, the cartilage, and the nasal skin. Reconstruction of the cartilaginous portion can be a surgical challenge. We demonstrate that titanium mesh can be an effective substitute for the cartilaginous portion of the nose in nasal reconstruction. We present five patients with nasal basal cell carcinoma who were treated by Mohs micrographic surgery. The partial loss of the cartilaginous structure was replaced by a 0.1 mm fenestrated titanium mesh. We have not observed any rejection or other complication in any of our patients. Good functional and aesthetic results have been obtained. Because of its biocompatibility, titanium mesh is a useful substitute for nasal cartilage. It avoids harvesting natural cartilage, reduces the risk of graft necrosis, and prevents morbidity in the donor area.

Key issues in nasal reconstruction

“…The use of titanium mesh has recently been reviewed when used for structural support in a series of large nasal sidewall defects [18]. Titanium enjoys low immunogenicity; however, extended follow-up is needed to determine extrusion rates, particularly in patients who may later require radiotherapy.…”

Titanium mesh in reconstructive surgery of the nasal pyramid. Follow‐up of our 11 initial cases

“…An efficient way to replace the cartilage and nasal bones is the employment of allogenic materials such as titanium mesh or porous polyethylene. The titanium mesh gives appropriate support to the flap, but as in the case of polyethylene, it features a series of disadvantages, such as the possibility of infection of the mesh, extrusion, interference with nuclear magnetic resonance imaging, and the risk of radionecrosis if postsurgical radiotherapy is required . We decided to assess the safety of the titanium mesh as a cartilage substitute in nasal reconstruction.…”

Titanium mesh in the reconstruction of a malar defect: a case report

“…The use of allografts, especially titanium, is well established in the repair of defects in the nasal, fronto‐zygomatico‐orbital, maxillary, and temporal areas. Although it is frequently used in maxillofacial procedures, this technique is uncommon in dermatologic surgery.…”

“…Although it is frequently used in maxillofacial procedures, this technique is uncommon in dermatologic surgery. Because titanium mesh has been used successfully in nasal reconstruction in our center, we employed this technique in a mid‐face reconstruction.…”

“…It is malleable but firm, and its use is not limited by the size of the defect. Titanium mesh does not migrate because connective tissue grows through and around its lattice structure, and it has proven to be a safe and reliable material that carries little risk for infection and achieves good functional results …”