Porous high-density polyethylene in facial reconstruction and revision rhinoplasty: a prospective cohort study

Abstract

IntroductionInitial methods which used human tissues as reconstruction materials caused different problems including rejection, limited shapes and infection. In 1970s, PHDPE (Medpor®) was introduced by its exclusive advantageous including no donor site morbidity, easily shaped and the minimal foreign body reaction. Hereby, we report our experience of using Medpor® in facial reconstruction especially in frontal reconstruction and orbital rim with a large sample size.MethodsThis study was a prospective cohort study. Surgical techniques included using Medpor® in reconstruction of lamina papiracea (LP) (15 patients), frontal bone (15 patients), orbital rim (18 patients) and open rhinoplasty (8 patients). All interventions on LP were performed by endoscopic procedures. All frontal operations were carried out by bicoronal incision. In orbital defects, we used subciliary incision.ResultsFrom all 56 patients, 1 case had primitive neuroectodermal tumor (PNET) of maxillary sinus. In that case, reconstruction of inferior orbital rim was not successful and extrusion was occurred after radiotherapy. In rhinoplasty and other experiences no extrusion or infection were detected within the next 1 to 3 years of follow up. There were not any palpable and visible irregularities under the skin in our experiences.ConclusionsIn this study the patients did not experience any complications during the follow up periods and the satisfaction was remarkable. Gathering these data gives rise to future review studies which can provide more organized evidences for replacing classic reconstructive methods by the presented material.

Polypropylene meshes and other alloplastic implants for soft tissue and cartilage nasal reconstructive surgery – a literature review

“…Medpor ® (high-density polyethylene), introduced in the 1970s, elicits minimal foreign body reaction 18 . Its interconnecting pore structure allows for fibrovascular ingrowth and integration of the surrounding tissue.…”

The use of collagen-coated polypropylene meshes for nasal reconstructive surgery

“…Moreover it is cheap, it can be easily folded and it restores the defect to its natural appearance [19]. Medpor (high-density porous polyethylene) is biocompatible, nonresorbable, resistant to stress [20], it allows osseous and soft tissues growth, has a small rate of infection and generates few foreign body reactions [21]. The most frequent complications quoted in the relevant literature regarding this type of mesh are: lateral displacement of the implant, fistula or abscess formation, implant extrusion and infection.…”

Surgical Nasal Implants: Indications and Risks

“…The first mention of a surgical attempt at nasal reconstruction using a nasal implant in the modern literature is attributed to Roussett, who employed gold and silver frameworks for nasal reconstruction in facial contouring beginning in 1828. 3 Through the remainder of the 19th century and into the early 20th century, various nasal implants were attempted with varying degrees of success. Many implants ultimately failed due to infection, extrusion, or migration.…”