Total Ear Reconstruction Using Porous Polyethylene

Abstract

Total ear reconstruction has been approached by several techniques involving autologous graft, prosthetic implant, and alloplastic implant options. Recent studies have shown the superiority of porous polyethylene (Medpor, Porex Surgical) reconstruction over autologous reconstruction based on improved aesthetic results, earlier age of intervention, shorter surgery times, fewer number of required procedures, and a simpler postoperative recovery process. A durable and permanent option for total ear reconstruction, like Medpor, can help alleviate the cosmetic concerns that patients with auricular deformities may be burdened with on a daily basis. In this article, the authors discuss the advantages of Medpor-based ear reconstruction and discuss recent advances in the surgical techniques involved, such as harvesting a temporoparietal fascia flap and full-thickness skin graft to adequately cover the Medpor framework and decrease extrusion rates.

Systematic Review of Clinical Applications of CAD/CAM Technology for Craniofacial Implants Placement and Manufacturing of Nasal Prostheses

“…Surgical reconstruction can be done with a bilobed flap, nasolabial flap, forehead flap, septal mucosal flap, S-shaped rotation flap, croissant-shaped flaps, modified V-Y flaps, radial forearm free flaps, and titanium mesh [ 10 ]. However, surgical reconstruction involving the entire nasal cavity poses significant challenge to reconstructive surgeons; therefore, it is currently only performed with satisfactory results in a few specialized medical centers around the world [ 11 ]. In contrast, the prosthetic rehabilitation of such defects is more commonly performed by covering the defect with silicone prosthesis while maintaining the patency of airway.…”

Review of Plastic Surgery Biomaterials and Current Progress in Their 3D Manufacturing Technology

“…After implanting it, fiber or bone tissue and blood vessels can grow into the hole, and the foreign body reaction is very light. There is a certain degree of bone conduction into the bone, which can repair the cheeks, orbital arch, orbital floor, upper and lower jaws, cheekbones, temporal, and ears [ 53 , 54 , 55 ]. Infection is the biggest problem it encounters in clinical application, so the disinfection of materials before surgery should be strict, and they should be placed in physiological saline containing antibiotics before use, so that the antibiotics after surgery can slowly dissolve in the pores, reducing the possibility of infection.…”

Vascularization Strategies for Porous Polyethylene Implants

“…T he face is considered as one of the most important body parts when undergoing surgery due to its permanent exposure and recognizability. 1 In craniofacial reconstructive surgery, facial-related tissue defects are commonly treated by the implantation of alloplastic biomaterials, particularly porous polyethylene (pPE), which has been developed and introduced into clinical practice in the early 1970s. 2 pPE is widely used for orbital floor restoration, [3][4][5] auricular reconstruction, 6-8 augmentation of the nasal architecture, 9,10 and contour restorations.…”

“…[14][15][16] Moreover, pPE exhibits an interconnected porous structure enabling fibrovascular ingrowth and, by this, supporting the incorporation of the material into the surrounding tissue. 1 In addition, the good thermoplasticity of pPE implants allows their convenient adaption to patientspecific anatomic conditions. 17 However, despite all these advantages, most plastic surgeons still prefer autologous tissue for defect reconstruction because of the risk of pPE-associated complications, 18 including infection, [19][20][21] migration, [22][23][24] and extrusion [25][26][27][28] of the implant material.…”