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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.

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According to most previous studies, inducing movements in internal laryngeal muscles by transcutaneous electrical stimulation (TES) was impossible. However, the movements have been reported after using needle electrodes inserted into the internal superior laryngeal nerve (ISLN). Herein, we aimed to apply an innovative TES protocol to cause movements in vocal folds. A short duration and high frequency electrical current was applied by two surface electrodes just above the entrance of ISLN to larynx. The subjects were 32 normal participants (mean age = 23.87; SD = 3.43). During TES application, the vocal folds' movements were examined by flexible videonasolaryngoscopy. Statistical paired t test was used to analyze the differences of vocal folds opening angle, in degrees, during rest and TES periods. Furthermore, the movements were judged by seven experienced speech pathologists via a 9-point rate scale from -1 (any abduction) to 8 (complete adduction). The mean vocal folds adduction increased by 35.68° (t = 9.35, p > 0.001) due to TES application. The mean qualitative scores assigned by raters to each subject were between 6 and 7 points, which indicate an acceptable adduction in vocal folds through TES. Unlike previous studies, the applied TES protocol in this research induced significant vocal fold movements. This might be attributed to our different stimulation parameters, which were designed to penetrate deeply and stimulate ISLN specifically. It is worth noting that we introduced a novel TES protocol, which should be confirmed and then examined as a complementary therapy for neurologic voice disorders in future studies.