The use of porous polyethylene implants to correct nasal valve collapse

Ramakrishnan, Jeevan; Danner, Christopher; Yee, Suzanne W.

doi:10.1016/j.otohns.2006.11.010

Cited by 24 publications

(19 citation statements)

References 17 publications

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“…Most recently authors have reported the use of implants to strengthen one or both of the nasal valves. Turegun31 used a saddle‐shaped porous polyethylene implant to reconstruct the middle nasal vault, whereas Ramakrishnan46 used the same material as an alar batten. Both report high success rates, although the latter author reported an extrusion rate of 21%.…”

Section: Discussionmentioning

confidence: 92%

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Surgical techniques for the treatment of nasal valve collapse

2009

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A variety of focussed surgical techniques are described to deal with nasal valve collapse. We could find no randomized controlled trials on nasal valve surgery. Research in nasal valve surgery is frequently driven by technical description of surgical technique rather than the establishment of evidence of long-term patient benefit. Although our understanding of the role of the nasal valve in the pathophysiology of nasal obstruction has improved vastly, the myriad of surgical techniques described perhaps reflects our uncertainty in choice of technique and in degree of patient benefit.

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Section: Discussionmentioning

confidence: 92%

“…The surgical techniques described addressed collapse of the INV or ENV or both. The studies were grouped on this basis and are presented in Tables I, II, and III 7–48. The lack of any high‐quality studies precludes the pooling of data and thus meta‐analysis is neither possible nor appropriate.…”

Section: Resultsmentioning

confidence: 99%

Surgical techniques for the treatment of nasal valve collapse

2009

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“…Human data suggest that non‐absorbable alloplastic materials have undesired complications including extrusions or infections following their use in nasal surgeries. Ramakrishnan and colleagues reported an extrusion rate of 21% (4 of 12 patients and 5 of 24 implants) using porous polyethylene as the implant material . Winkler et al reported an extrusion rate of 12% in 662 patients with implantations of high‐density polyethylene and polytetrfluoroethylene for nasal reconstruction .…”

Section: Discussionmentioning

confidence: 99%

“…Ramakrishnan and colleagues reported an extrusion rate of 21% (4 of 12 patients and 5 of 24 implants) using porous polyethylene as the implant material. 17 Winkler et al reported an extrusion rate of 12% in 662 patients with implantations of high-density polyethylene and polytetrfluoroethylene for nasal reconstruction. 18 This study demonstrated that the rod implants made of PLA copolymers elicited expected and contained inflammatory response, with no extrusions observed through 24 months (total of 66 rods placed).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of absorbable PLA nasal implants in an ovine model

Rippy¹,

Baron

Rosenthal

et al. 2018

Laryngoscope Investig Oto

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ObjectiveTo examine biocompatibility and absorption profile of a poly (L‐lactide‐co‐D,L‐lactide) 70:30 nasal implant.MethodsIn an ovine model, 66 rod‐shaped absorbable implants were placed in 11 nasal dorsa. The sheep were sacrificed at 1.5 (N = 3), 6 (N = 3), 12 (N = 3), 18 (N = 1), and 24 months (N = 1). The nasal dorsum was harvested from each animal. Gross and histopathological examinations were performed.ResultsThere were no postoperative complications, signs of infection, or tissue rejection throughout follow‐up time points. Upon sacrifice, no abnormalities were identified during gross pathological examinations. The histology of the implant sites at all time points showed the implants were fully encapsulated through 12 months. The inflammatory reaction to the implants was minimal to mild at 1.5, 6, and 12 months. At 18 months the implant material was in the mass loss phase, being actively absorbed. During this phase, the inflammatory reaction within the fibrous connective tissue capsule reached expected moderate levels. By 24 months, the inflammatory reaction had diminished in most implantation sites and complete absorption of the rod implants was noted at some sites with nodular bundles of mature collagenized fibrous tissue replacing the implant, devoid of an inflammatory infiltrate.ConclusionBiocompatibility of the poly (L‐lactide‐co‐D,L‐lactide) 70:30 material was demonstrated when used as a nasal implant in the nasal dorsum ovine model. Absorption of the implant occurred approximately 18 to 24 months postoperatively, and the implant site was replaced with collagenized fibrous tissue.Level of EvidenceNA.

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“…29,30 The use of autogenous tissue avoids the problem of incompatibility, but sometimes fails to provide necessary volume to provide the size and shape. However, septal and conchal cartilages often do not provide adequate volume.…”

Section: Nasal and Premaxillary Augmentationmentioning

confidence: 99%