The Use of High-Density Porous Polyethylene as a Custom-Made Nasal Spreader Graft

Abstract

The concept and technique of using high-density porous polyethylene (HDPP), a nonresorbable synthetic material, for nasal spreader grafts, are presented. This material is thought to be particularly useful in revision (secondary or tertiary) rhinoplasty, in which internal valve collapse frequently is confronted and septal cartilage often is unavailable because it has been harvested for spreader or other grafts. Sold as a thin plain sheet (0.85 x 38 x 50 mm) that can be cut to an appropriate size for spreader grafts, HDPP is a ready-to-use material commercially available on the market. Because HDPP permits ingrowths of fibrous tissue inside and around, it is a nonabsorbable material that stabilizes the upper lateral cartilages in their new position and maintains the appropriate internal valve angle. The authors used this material for 15 patients undergoing secondary (n = 12) and tertiary (n = 3) rhinoplasty because of valvular collapse. During the mean follow-up period of 16 months (range, 8-30 months), neither complication nor recurrence of airway obstruction occurred.

Our experience with spreader graft in septorhinoplasty by open approach

“…4 The other materials that can be used as spreader graft are hyaluronic acid, high density porus polyethylene, calcium hydroxyl apatite and polymer of polylactic and polyglycolic acid. [5][6][7][8][9] There is still controversy regarding the unilateral or bilateral placement of spreader graft. Many authors support the view of putting graft unilaterally, mainly on concave side for correcting high septal deviation.…”

Spreader graft in septo-rhinoplasty

“…Gurlek et al 1 . used high density porous polyethylene (HDPP), a non resorbable synthetic material for the nasal spreader graft in 15 patients and during the mean follow-up period of 16 months, there was no complication nor any recurrence of airway obstruction was noted.…”

“…It is indicated to maintain or reconstruct the dorsal nasal roof, to maintain or reconstruct the internal nasal valve, to straighten high dorsally deviated septum and to recreate dorsal aesthetic line 1 . It can be placed endonasally or by external rhinoplasty approach.…”

Struktur-Transplantate und Nahttechniken in der funktionell-ästhetischen Rhinochirurgie

“…Ein Vorteil dieses Materials stellt seine von relativ gro ß en Poren durchsetzte Struktur dar, welche ein Einwachsen von Gewebe erm ö glicht [59 -61] . Neben der Implantation ü ber dem Nasenr ü cken wird zunehmend ü ber die Anwendung vorgefertigter Implantate im Bereich der Nasenspitze berichtet [62,63] . Die relative rigide Struktur des Materials wird als Risikofaktor einer m ö glichen Extrusion und Infektion angef ü hrt, vor allem bei Implantation in den mobilen Anteilen der Nase oder unter einer relativ d ü nnen Weichteilbedeckung [64] .…”