Gesichtsschädelaugmentationen mit porösen Polyethylenimplantaten (Medpor®)

Abstract

Porous polyethylene implants showed a good fibrovascular integration without encapsulation under the light microscope. Giant cells were detected on the surface of the implants. Besides this there was evidence for resorption of the implant material. Fixation with titanium screws is very effective. No implant dislocation or implant fracture occurred. The implants showed high volume stability and were easily handled and contoured. It is not possible to visualize Medpor implants with current imaging techniques, because polyethylene shows no contrast.

Components of the Plasminogen Activation System Promote Engraftment of Porous Polyethylene Biomaterial via Common and Distinct Effects

“…PPE implants are available for numerous applications ranging from orbital floor reconstruction [ 2 ] over auricular reconstruction [ 3 ] to facial contour implants [ 4 ]. This implant material has proofed to be biocompatible, long-term stable, non-soluble, and non-resorbable over a period of more than 30 years of clinical use [ 5 – 7 ]. However, there are applications which are less favorable for implant integration, such as rhinoplasty and reconstructive nose surgery [ 8 ] as well as reconstructions in irradiated or scar tissue, where blood supply is weak [ 9 ].…”

Maxillofacial reconstruction with Medpor porous polyethylene implant: a case series study

“…Use of Medpor implants for areas like the ear, nose and maxilla in syndromic patients is associated with a higher risk of implant failure 39 . A study by Gosau et al 41 showed fibrovascular integration without encapsulation under light microscopy for the Medpor implant. They detected giant cells on the surface of the implants and evidence of implant material resorption.…”

Biomaterials in skull base surgery

“…It has pores of 150–250 µm, a size suitable for the immigration of autologous connective tissue cells, it can be formed intraoperative to a moderate extent [23], [58] and is not relevantly resorbed. However, foreign body giant cells are found histologically in the surroundings which contain the material, so at least minimal degradation must be assumed [60]. It is encased by a connective tissue membrane: encasing and cell immigration thus contribute to stabilization of the implant, in supplement to the titanium screws with which it is customarily affixed [60].…”

“…However, foreign body giant cells are found histologically in the surroundings which contain the material, so at least minimal degradation must be assumed [60]. It is encased by a connective tissue membrane: encasing and cell immigration thus contribute to stabilization of the implant, in supplement to the titanium screws with which it is customarily affixed [60]. Due to the limited formability and limited shock stability, this material is only suitable for smaller defects, since it cannot compete in the same category with individually preformed implants and the possibility they offer with respect to contouring and shock resistance.…”

“…Due to the limited formability and limited shock stability, this material is only suitable for smaller defects, since it cannot compete in the same category with individually preformed implants and the possibility they offer with respect to contouring and shock resistance. Gosau [60] had to remove the implant in two of his 27 patients due to infections conducted to the upper jaw, which reveals the problems in use near potentially infectious organs (teeth, sinuses). Moreover, polyethylene implants have the disadvantage that they cannot be visualized in conventional X-rays and only poorly in the CT.…”