• Journal of Korean Neurosurgical Society
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• v.38 no.2
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• pp.96-101
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• 2005

Objective : This paper describes our experience and implant technique for cranioplasty of a large cranial defects using a porous polyethylene implant[Medpor] and compares the results with polymethylmethacrylate[PMMA]. Methods : Sixteen cranioplasties were performed using Medpor[n= 10] and PMMA[n=6] implants between June 2003 and January 2005. The criterion for patient enrollment was a defect larger than 10cm in diameter. This study compared the operation times and complications. Results : The operation times ranged from 105 to 250minutes[Mean $180^{\circ}{\pm}44minutes$) in Medpor and from 185 to 460minutes [mean 128minutes] in PMMA. The absolute operation times were shorter using the Medpor implant and the differences were statistically significant[P=0.030]. Satisfactory cosmetic results were obtained in all cases using the Medpor implant and with no implant-related complications. Bone ingrowth to the medpor implant was presumed to be the result on an increase in Houndsfield units of the implant, particularly at the marginal areas in the serial follow-up brain computed tomography images. Conclusion : It is believed that the properties of a Medpor implant make this implant an good alternative to the existing methods of a cranial contour correction. However, a further follow-up study will be needed.

• Journal of Korean Neurosurgical Society
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• v.46 no.3
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• pp.195-198
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• 2009

Objective : Medpor porous polyethylene was used to reconstruct small bone defects (gaps and burr holes) along a craniotomy bone flap. The feasibility and cosmetic results were evaluated. Methods : Medpor Craniotomy Gap Wedges, V and T, were designed. The V implant is a 10 cm-long wedge strip, the cross section of which is an isosceles triangle with a 4 mm-long base, making it suitable for gaps less than 4 mm after trimming. Meanwhile, the Medpor T wedge includes a 10 mm-wide thin plate on the top surface of the Medpor V Wedge, making it suitable for gaps wider than 4 mm and burr holes. Sixty-eight pterional craniotomies and 39 superciliary approaches were performed using the implants, and the operative results were evaluated with respect to the cosmetic results and pain or tenderness related to the cranial flap. Results : The small bone defects were eliminated with less than 10 minutes additional operative time. In a physical examination, there were no considerable cosmetic problems regarding to the cranial bone defects, such as a linear depression or dimple in the forehead, anterior temporal hollow, preauricular depression, and parietal burr hole defect. Plus, no patient suffered from any infectious complications. Conclusion : The Medpor Craniotomy Gap Wedge is technically easy to work with for reconstructing small bone defects, such as the bone gaps and burr holes created by a craniotomy, and produces excellent cosmetic results.

• Archives of Craniofacial Surgery
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• v.9 no.2
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• pp.55-61
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• 2008

Purpose: The purpose of this study is to evaluate the effectiveness of internal fixation method of $Medpor^{(R)}$ implant with $BioSorb^{TM}FX$ screw which is used for prevention of enophthalmos in posteriorly extended large orbital floor fracture. Methods: From Jun. 1997 to Dec. 2007, 21 patients who were diagnosed with posteriorly extended large orbital floor fractures were classified into two groups. One group(n=11) had undergone reduction surgery with regular $Medpor^{(R)}$ sheets without any fixation method, while the other group(n=10) had their $Medpor^{(R)}$ sheets fixed with the $BioSorb^{TM}FX$ screws. The two groups were evaluated by comparison of their enophthalmos degree and effectiveness. Results: In the non-fixation group, six patients had enophthalmos preoperatively and three of them showed persistent enophthalmos postoperatively. In postoperative CT examination, displacement of $Medpor^{(R)}$ implant with soft tissue impaction into maxillary sinus was observed in the patients. In the screw fixation group, three patients had enophthalmos preoperatively, but none of them suffer from complication such as residual enophthalmos, soft tissue impaction, muscle entrapment or optic nerve compression postoperatively. Conclusion: Internal fixation method of $Medpor^{(R)}$ implant with $BioSorb^{TM}FX$ screw on the medial surface of orbital floor provides firm stabilization of implants and surrounding soft tissues and can be an effective option especially when postoperative implant displacement or malposition was expected.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.2
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• pp.127-132
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• 1998

$Medpor^{(R)}$(porous polyethylene) Surgical Implants are used for the augmentation or restoration of bony contour in craniofacial defects. The purpose of this study is to evaluate the ingrowth of soft tissue and bone after application in calvaria of rats. The experiment was carried out in 60 rats. The reflected periosteum was resutured after implantation of $Medpor^{(R)}$ as a experimental site, while in the calvarial bone the reflected periosteum resutured without implantation as a control site. The histologic examination was performed after 1-, 2-, 4-, 8-, 12-, 24-weeks implantation in calvaria of rats. I concluded that there was abundant ingrowth of soft tissue and bone without any adverse tissue response and that it shows good stability.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.142-154
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• 2000

The purpose of this study is to evaluate the difference in healing of $Medpor^{(R)}$ implants of two different thickness (1.5mm and 4.5mm) and the effects of methylprednisolone on the healing process. Light microscopic and scanning electron microscopic examinations, and hardness measurement were made in 100 rats 2, 4, or 8 weeks postoperatively. The 1.5mm thin implants were taken better than the 4.5mm thick implants. The inflammatory responses were reduced after application of methylprednisolone with arrangement and amount of bone matrix deposited being more irregular and reduced in bulk than in the control group. To hasten postoperative healing after $Medpor^{(R)}$ implantation, the thinner material should be used and steroid injection should be avoided.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.481-484
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• 2009

Purpose: Cleidocranial dysostosis is a rare hereditary disorder affecting bones that develop by intramembranous formation. The typical features include excessive growth of transverse diameter of the skull, hypoplastic clavicles, low height and characteristic facial features. Methods: A 28 years old female patient visited by frontal area depression. The diagnosis was performed by computed tomographic study and radiographic imaging. The patient has widely opened anterior fontanelle, partial fused metopic suture, multiple wormian bone and supernumenary impacted teeth. Under the coronal incision, we exposed depressed frontal area and corrected with Medpor block carving. Results: Postoperatively, frontoparietal skull was aestheticlly improved and she was satisfied with the results. Conclusion: Authors report a case of cleiodocranial dysostosis who has been done correction of abnormal skull shape by Medpor$^{(R)}$ insertion.

• Archives of Plastic Surgery
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• v.35 no.6
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• pp.675-679
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• 2008

Purpose: In the orbital floor fracture, sensory impairment due to the damage of the infraorbital nerve is one of the most common symptom and complication. In this report, we have the assumption that tailoring of $medpor^{(R)}$ for decompression may have correlations to the damage and regeneration of the nerve. Methods: Among patients who had open reduction for pure orbital floor fracture in our hospital from March 2005 to March 2008, we selected 80 cases. In 40 cases, we inserted tailored $medpor^{(R)}$, and in other 40 cases, non-tailored $medpor^{(R)}$ was inserted. Patient's reports were obtained and analyzed, and the pin-prick test and the 2-point discrimination test on the infraorbital nerve regions were done for testing the sensory impairments. Results: The results show that the patients who adopted sculpture of $medpor^{(R)}$ showed higher tendency of recovery of sensory impairments in the patient's subjective report, static touch sensation, static two point discrimination using. And in postoperative 3 months, there are statistically significant recovery of sensory symptoms, signs and the result of sensory tests. Conclusion: From these results, tailored $medpor^{(R)}$ in reconstruction of orbital wall fracture may improve recovery of sensory impairments for decreasing of compression of infraorbital nerve.

• Archives of Plastic Surgery
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• v.36 no.2
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• pp.167-173
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• 2009

Purpose: The key points of treatment of cryptotia are the elevation of invaginated ear helix and the correction of deformed cartilage. Prevention of stabilized cartilage contouring from returning to the previous state is also important. The authors carried otoplasty by modified Onizuka's method or Ohmori's method that conchal cartilage graft or high density polyethylene implant(MEDPOR$^{(R)}$) graft served as fixation after spreading posterior aspect of adhered antihelix and a splint for prevention of recurrence of cartilage deformities. The aim of this study is to reveal the availability of the high density polyethylene implant(MEDPOR$^{(R)}$) graft for the correction of cryptotia. Methods: We have repaired 17 cryptotic deformities using cartilage graft from cavum of concha(12 cases) or high density polyethylene implant(5 cases) for correction of deformed cartilage. We investigate the operative time, complications, and satisfaction of postoperative ear shape on both autogenous cartilage graft group and high density polyethylene implant graft group. Results: There was 1 case of reinvagination on autogenous cartilage graft group. Implant exposure was occurred on high density polyethylene implant graft group, as 1 case. These were statistically no differences between autogenous cartilage graft group and high density polyethylene implant graft group to the satisfaction of ear shape. Conclusion: High density polyethylene implant(MEDPOR$^{(R)}$) present an alternative to autogenous material as they allow of fibrovascular ingrowth, leading to stability of the implant and decreased infection rates. The correction of deformed cartilage by using the high density polyethylene implant(MEDPOR$^{(R)}$) is a good option for the treatment of cryptotia.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.729-734
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• 2007

Purpose: The operative treatment for blow-out fracture involves restoration of intra-orbital soft tissue and bony structural integrity. There are several methods for reconstruction of inferior blow out fracture. We report reduction of inferior blow-out fracture with urinary balloon catheter in comparison with $Medpor^{(R)}$ using group to complication rate. Methods: A retrospective study was performed on 67 patients who underwent inferior orbital blow-out fracture reconstruction with $Medpor^{(R)}$ implant or urinary balloon catheter following between 2003 and 2006. Hospital records were reviewed especially for preoperative and postoperative enophthalmos, diplopia, extraocular muscle movement limitations, and hypoesthesia between $Medpor^{(R)}$ implant group and balloon catheter using group. Results: There was no significant statistical difference between both groups on incidence of postoperative complications of enophthalmos, diplopia, extraocular muscle movement limitations, and hypoesthesia. Postoperative infection, ectropion were absent in both groups.Conclusion: The use of urinary balloon catheter is simple, fast and inexpensive. Urinary balloon catheter is an alternative and reliable use for reduction of inferior orbital blow-out fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.4
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• pp.363-367
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• 2011

Genioplasy with osteotomy is a flexible and useful procedure. However, osteotomy can cause different types of morbidity. Chin augmentation with porous polyethylene ($Medpor^{(R)}$) has become popular in the recent years. Porous polyethylene ($Medpor^{(R)}$) is an excellent biomaterial for reconstructing facial deformities. $Medpor^{(R)}$ has a porous architecture, which prevents capsule formation and decreases the degree of foreign-body reaction. In addition, it can be easily cut with scissors and molded, and it also maintains its shape. We report here on a satisfactory case of chin augmentation with using porous polyethylene ($Medpor^{(R)}$).