Application of Medical Imaging Procedures in Surgery Implanting in Cancerology With the Aim to Reduce Invasive Acts

Application of Medical Imaging Procedures in Surgery Implanting in Cancerology With the Aim to Reduce Invasive Acts

Aero digestive Cancer patients treated by external head and neck radiotherapy and/or by curie-therapy and/or mandible reconstruction by microanastomosed fibula flaps. The purpose of the study is to Investigate the accuracy of implants insertion in the anteroposterior way, using radiosurgical guidance.

• Investigate the accuracy of inserting implants in the vertical way and in angulation, on irradiated native mandible or on microanastomosed fibula flaps
• Investigate the accuracy of inserting implants in the anteroposterior way, in the vertical way and in angulation for all the involved patients (meaning on irradiated native mandible or on microanastomosed fibula flaps)
• Investigate the delay of mucous healing
• Estimate the prosthetic function
• Evaluate the osteonecrosis rate after radiation with traumatic etiology due to implantation
• Estimate the implant rate due to minimally invasive flaps
• Estimate the implant rate due to pure trans mucosa way
• Estimate the post surgical therapeutic success after 1 year

Inclusion Criteria:

• age over 18
• Performance status over 70
• Histological evidence of upper digestive tract cancer
• History of cranial / facial radiotherapy or brachytherapy and/or microvascular fibula transfer.
• Bone volume sufficient to support an implant.
• Mandatory affiliation with a social security system
• Written, voluntary, informed consent

Exclusion Criteria:

• Patient with evolutive malignant disease
• Contraindication to general anesthesia
• Concurrent disease contra-indicating implant surgery (risk of infectious endocarditis, uncontrolled diabetes, HIV, evolutive neoplasia…)
• Patient enrolled in another clinical trial including chemotherapy
• Pregnant or lactating woman
• Anticipation of an impossible follow-up
• Patient deprived of freedom