Lidingö Clinic, Torsvägen 30, Lidingö, 181 61, Stockholm, Sweden.
Aesthetic Plast Surg. 2012 Aug;36(4):917-27. doi: 10.1007/s00266-012-9911-4. Epub 2012 Jun 9.
Medpor is a biocompatible, porous, high-density polyethylene implant material used as a skeleton substitute. During the last two decades, it has been successfully applied for aesthetic contour enhancement and at reconstruction of the facial skeleton. Reports on the long-term host tissue tolerance of Medpor are sparse. Use of foreign materials in nasal reconstruction has always been and still is controversial. The main contra-argument maintains that it is not known how alloplastic materials are tolerated by the human body in the long term. This study brings such data concerning the biocompatibility of Medpor. The author has 16 years of experience working with Medpor implants, including its use in rhinoplasty, chin augmentation, and malar augmentation. In this prospective study from 1996 to 2012, Medpor was used in 118 implants for 102 patients. The most frequent indications were nose deformity (n=61), chin hypoplasia (n=33), and malar hypoplasia (n=6). The follow-up periods ranged from 6 months to 15 years (median, 7 years). Of 42 difficult nasal reconstructions performed with the assistance of Medpor, 28 were catastrophe noses that had undergone two to four previous surgeries elsewhere. A total of 19 patients had saddle nose deformity. Of the nasal reconstructions, 85 % had a smooth clinical course, with results remaining stable during the observation time. Five biopsies confirmed soft tissue ingrowths and collagen deposition, with subsequent vascularization. All complications could be mastered. Two dorsal struts and two chin implants required trimming. Infection occurred in three rhinoplasty cases, and partial extrusion occurred in two cases. All augmented chins and malar prominences were firm and bony-like at palpation. Of the 106 Medpor implants in the followed-up patients, some were trimmed or removed, but 97 implants (91%) remained unchanged. Implantation of porous polyethylene in the facial region is a safe procedure. Currently, Medpor seems to be the best alloplastic material available as a facial bone substitute. It is long-lasting, with a low frequency of complications, morbidity similar to procedures involving autologous grafts, and high overall patient satisfaction.
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Medpor 是一种生物相容性、多孔、高密度聚乙烯植入物材料，可用作骨架替代物。在过去的二十年中，它已成功应用于美容轮廓增强和面部骨骼重建。有关 Medpor 的长期宿主组织耐受性的报告很少。在鼻重建中使用异物一直存在争议，并且仍然存在争议。主要的反论点认为，尚不清楚长期以来人体对同种异体材料的耐受性如何。这项研究提供了有关 Medpor 生物相容性的此类数据。作者在使用 Medpor 植入物方面拥有 16 年的经验，包括在隆鼻术、下巴增大术和颧骨增大术中的应用。在这项从 1996 年至 2012 年的前瞻性研究中，102 名患者的 118 个植入物中使用了 Medpor。最常见的适应症是鼻畸形（n=61），下巴发育不全（n=33）和颧骨发育不全（n=6）。随访时间从 6 个月到 15 年（中位数，7 年）。在使用 Medpor 辅助的 42 例复杂的鼻重建中，有 28 例是灾难性的鼻子，这些鼻子在其他地方进行了两次至四次先前的手术。共有 19 名患者患有鞍鼻畸形。在鼻重建中，85％的患者临床过程平稳，在观察期间结果保持稳定。5 次活检证实软组织向内生长和胶原沉积，随后出现血管化。所有并发症均能得到控制。两根背侧支柱和两根下巴植入物需要修剪。在 3 例隆鼻病例中发生感染，在 2 例病例中发生部分挤出。所有增大的下巴和颧骨突出均在触诊时感觉坚硬，类似于骨样。在随访患者的 106 个 Medpor 植入物中，一些被修剪或取出，但 97 个植入物（91％）保持不变。在面部区域植入多孔聚乙烯是一种安全的手术。目前，Medpor 似乎是一种可用作面部骨替代物的最佳同种异体材料。它持久耐用，并发症发生率低，与涉及自体移植物的手术相似，且总体患者满意度高。
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