Medpor

Medpor
  • 文章类型: Journal Article
    背景:耳廓重建是整形和重建手术中最具挑战性的手术之一,框架材料的选择对外科医生和患者来说都是一个关键的决定。这项荟萃分析比较了使用肋软骨进行自体耳廓重建与使用多孔聚乙烯植入物进行同种异体重建的结果。
    方法:使用PubMed和Embase数据库进行了文献综述,以检索2000年1月至2024年6月之间发表的文章。分析的结果包括术后并发症,如框架暴露,感染,皮肤坏死,血肿,和肥厚性疤痕,以及患者的满意度。使用R软件中的“metaprop”功能对每项选定研究的重建结果比例进行统计分析。
    结果:14篇文章符合我们的纳入标准。接受聚乙烯植入物重建的组表现出更高的框架暴露率,感染,皮肤坏死,而自体重建组的血肿和肥厚性瘢痕发生率较高。在所有的并发症中,框架暴露是唯一显示两组之间有统计学显著性差异的一个(p<0.0001).在患者满意度方面,那些接受自体软骨重建的人报告了更高的满意度,尽管这一差异在荟萃分析中没有达到统计学意义(p=0.076).
    结论:术后感染等并发症无统计学差异,血肿,皮肤坏死,使用自体肋软骨重建耳廓和使用聚乙烯植入物重建耳廓之间的肥厚性疤痕。然而,使用聚乙烯植入物的重建显示出明显更高的框架暴露率。
    BACKGROUND: Auricle reconstruction is among the most challenging procedures in plastic and reconstructive surgery, and the choice of framework material is a critical decision for both surgeons and patients. This meta-analysis compared the outcomes of autologous auricle reconstruction using costal cartilage with those of alloplastic reconstruction using porous polyethylene implants.
    METHODS: A literature review was conducted using the PubMed and Embase databases to retrieve articles published between January 2000 and June 2024. The outcomes analyzed included postoperative complications such as framework exposure, infection, skin necrosis, hematoma, and hypertrophic scars, as well as patient satisfaction. The proportions of reconstructive outcomes from each selected study were statistically analyzed using the \"metaprop\" function in R software.
    RESULTS: Fourteen articles met our inclusion criteria. The group undergoing polyethylene implant reconstruction exhibited higher rates of framework exposure, infection, and skin necrosis, whereas the autologous reconstruction group experienced higher rates of hematoma and hypertrophic scars. Of all the complications, framework exposure was the only one to show a statistically significant difference between the two groups (p < 0.0001). In terms of patient satisfaction, those who underwent autologous cartilage reconstruction reported a higher rate of satisfaction, although this difference did not reach statistical significance in the meta-analysis (p = 0.076).
    CONCLUSIONS: There is no statistically significant difference in postoperative complications such as infection, hematoma, skin necrosis, and hypertrophic scars between auricle reconstructions using autologous costal cartilage and those using polyethylene implants. However, reconstructions with polyethylene implants show a significantly higher rate of framework exposure.
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  • 文章类型: Journal Article
    小耳畸形重建是由面部整形和重建外科医生执行的复杂程序,需要专家了解耳朵的三维结构。本文通过历史概述了微生重建的演变。由小骨症外科医生博士开创的技术。RadfordTanzer,BurtBrent,SatoruNagata,和FrançoiseFirmin将与关于多孔聚乙烯利用的额外摘录一起描述(Medpor;Stryker,美国)。读者的目标是能够总结每种主要重建技术的方法,比较技术上的差异,并了解每种方法的优缺点。
    Microtia reconstruction is a complex procedure performed by the facial plastic and reconstructive surgeon and requires an expert understanding of the three-dimensional structure of the ear. This article provides an overview of the evolution of microtia reconstruction through history. Techniques pioneered by microtia surgeons Drs. Radford Tanzer, Burt Brent, Satoru Nagata, and Françoise Firmin will be described along with an additional excerpt on the utilization of porous polyethylene (Medpor; Stryker, USA). The objective for the reader is to be able to summarize approaches of each major reconstructive technique, compare the differences in techniques, and gain an understanding of the advantages and disadvantages of each approach.
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  • 文章类型: Case Reports
    \“冷冻眼\”是治疗眼眶爆裂性骨折后非常罕见的后遗症,需要植入植入物。
    植入物可能会错误地撞击眼和眼外肌肉,导致眼睛运动异常。
    我们介绍了一位56岁的男性,其眼部植入物撞击肌肉,导致“冻结的眼睛”,并感染了植入物。
    将其取出并手术矫正。手稿描述了细节,并讨论了导致“冻结之眼”的可能机制。
    UNASSIGNED: \"Frozen Eye\" is a very uncommon sequel after treatment of orbital blowout fractures requiring implant placement.
    UNASSIGNED: The implant may faultily impinge on the ocular and extra-ocular muscle(s), causing the abnormality in the movement of the eye.
    UNASSIGNED: We present a 56-year-old male whose ocular implant impinged on muscle, causing \"frozen eye\" and had an infected implant.
    UNASSIGNED: The same was removed and surgically corrected. The manuscript describes the details and discusses the possible mechanism that led to the \"Frozen Eye\".
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  • 文章类型: Journal Article
    BACKGROUND: Auricular reconstruction for microtia is most frequently performed using autologous costal cartilage (ACC) or porous polyethylene (PPE) implants. Short-term results are generally promising, but long-term results remain unclear. Long-term outcomes were explored in this systematic review, and minimal reporting criteria were suggested for future original data studies.
    METHODS: A systematic literature search was conducted in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials from inception through October 14, 2020. Articles on auricular reconstruction in patients with microtia using ACC or PPE were included if postsurgical follow-up was at least 1 year. Outcome reporting was split into separate publications, and results on complications were reported previously. This publication focused on long-term aesthetic, patient-reported, and sensitivity outcomes.
    RESULTS: Forty-one publications reported on these outcomes. Both materials led to aesthetically pleasing results and high rates of patient satisfaction. ACC frameworks grew similarly to contralateral ears, and the anterior surface of auricles regained sensitivity. Furthermore, postoperative health-related quality of life (HRQoL) outcomes were generally good. Data synthesis was limited due to considerable variability between studies and poor study quality. No conclusions could be drawn on the superiority of either method due to the lack of comparative analyses.
    CONCLUSIONS: Future studies should minimally report (1) surgical efficacy measured using the tool provided in the UK Care Standards for the Management of Patients with Microtia and Atresia; (2) complications including framework extrusion or exposure, graft loss, framework resorption, wire exposure and scalp/auricular scar complications and (3) HRQoL before and after treatment using the EAR-Q patient-reported outcome measure (PROM).
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  • 文章类型: Journal Article
    背景:小耳畸形是一种罕见的疾病,其特征是畸形甚至完全没有耳廓。重建通常使用自体肋软骨(ACC)或多孔聚乙烯植入物(PPE)进行。然而,两种方法的长期结局尚不清楚.
    目的:本系统综述旨在分析长期并发症,并为未来原始数据研究提出最低限度的报告标准。
    方法:在MEDLINE进行了系统的文献检索,EMBASE和Cochrane中央受控试验登记册从开始到2020年10月14日。包括有关使用ACC或PPE的小耳畸形患者的耳廓重建的文章,前提是随访期至少为一年。该出版物着重于术后随访至少一年的患者报告的长期并发症。
    结果:29篇文献报道了长期随访中的并发症。未报告总的长期并发症发生率。在ACC重建后的长期随访中,个体并发症的发生率小于10%,在PPE重建中小于15%。即使在ACC重建后五年以上的长期随访后,仍报告了框架吸收和导线暴露。虽然关于PPE重建的长期结果的报道有限。由于异质性和研究质量差,数据综合受到限制。
    结论:未来的研究应报告长期并发症,包括框架暴露或挤压,移植物丢失,框架吸收,导线暴露和头皮和耳廓瘢痕并发症。我们建议手术随访至少5年。
    BACKGROUND: Microtia is a rare disorder characterized by malformation or even complete absence of the auricle. Reconstruction is often performed using autologous costal cartilage (ACC) or porous polyethylene implants (PPE). However, the long-term outcomes of both methods are unclear.
    OBJECTIVE: This systematic review aimed to analyze long-term complications and suggest minimal reporting criteria for future original data studies.
    METHODS: A systematic literature search was conducted in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials from inception through October 14, 2020. Articles on auricular reconstruction in patients with microtia using ACC or PPE were included provided that the follow-up period was at least one year. This publication focused on long-term complications reported in patients with a postoperative follow-up period of at least one year.
    RESULTS: Twenty-nine publications reported on complications during long-term follow-up. Overall long-term complication rates were not reported. The incidence of individual complications during long-term follow-up was less than 10% after ACC reconstruction and less than 15% in PPE reconstruction. Framework resorption and wire exposure were reported even after an extended follow-up of more than five years after ACC reconstruction, while reports on the extended long-term results of PPE reconstruction are limited. Data synthesis was limited due to heterogeneity and poor study quality.
    CONCLUSIONS: Future studies should report on long-term complications including framework exposure or extrusion, graft loss, framework resorption, wire exposure and scalp and auricular scar complications. We recommend a surgical follow-up of at least five years.
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  • 文章类型: Journal Article
    UNASSIGNED: Treating orbital injuries is interesting and difficult in the facial trauma. The balance in facial proportions and also the facial esthetics are required to achieve an anatomical harmony.
    UNASSIGNED: To compare the functional results of individual reconstruction of orbital floor using either titanium mesh or Medpor in terms of various factors.
    UNASSIGNED: There were two study groups including eight subjects with orbital floor fracture, namely A (Medpor) and B (titanium mesh). Various parameters were analyzed postoperatively at intervals of 1 week, 3 week, 6th week, and 3 months after the surgery.
    UNASSIGNED: Comparison of the different time points with respect to pain scores in the two study groups by Wilcoxon matched pairs test was done. P value was significant in the study Group A with P = 0.0431* and was insignificant in the study Group B with P = 0.1088.
    UNASSIGNED: All three cases of titanium mesh in orbital floor reconstruction had signs of infection, tenderness, and radiographic proof after 1 week in two subjects and 3 weeks in one patient. Pain was seen in all eight patients 1 week postoperatively.
    UNASSIGNED: Although orbital reconstruction is a technique sensitive procedure both Medpore and Titanium mesh functions.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    Reconstruction of large cavities in the skull and facial regions is important not only to restore health but also for the correction of facial distortions. Every visible deformity in the facial region of the patient affects their mental wellness and perception by society, entailing both, deterioration of health, but also a decrease in the performance in society, which translates into its productivity. With the progressive degradation of the natural environment, cancer, in the coming years, will be on the leading causes of morbidity and mortality. The review focuses on two main aspects: (i) the causes of injuries leading to the necessity of removal of orbital cavities occupied by the tumor and then their reconstruction, with the focus on the anatomical structure of the orbital cavity, (ii) the materials used to reconstruct the orbital cavities and analyze their advantages and disadvantages. The manuscript also underlines the not yet fully met challenges in the area of facial- and craniofacial reconstruction in people affected by cancer.
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  • 文章类型: Journal Article
    UNASSIGNED: Our aim was to evaluate and compare the clinical outcomes after implantation of the silicone-plate (model FP7) and porous polyethylene-plate (model M4) Ahmed Glaucoma Valves.
    UNASSIGNED: This was a prospective, multicenter, comparative series. A total of 52 eyes (52 patients) were treated with either the silicone or porous plate Ahmed Glaucoma Valve implant. Hypertensive phase was defined as intraocular pressure >21 mmHg during the first 3 months postoperatively. Success was defined as 5 mmHg ≤intraocular pressure ≤21 mmHg (with or without additional glaucoma medications), without loss of light perception and without additional glaucoma procedures. Patients were monitored for 1 year after surgery.
    UNASSIGNED: The pre-operative intraocular pressure was 29.9 ± 6.6 mmHg and 33.8 ± 10.5 in the silicone-plate and porous-plate groups, respectively (P = 0.118). At 12 months after surgery, the mean intraocular pressure was 13.6 ± 4.7 mmHg in the silicone-plate group and 17.9 ± 10.9 mmHg in the porous-plate group (P = 0.141). The mean number of glaucoma medications at 12 months was 1.64 ± 1.40 mmHg and 1.89 ± 1.54 mmHg in the silicone- and porous-plate groups, respectively (P = 0.605). Hypertensive phase was not significantly different in the two groups (50.0% of the silicone-plate and 57.7% of the porous-plate groups, P = 0.578). At 12 months after surgery, the percent success for the silicone-plate and porous-plate groups was 88.5% and 53.8%, respectively (P = 0.005). Complications were similar in the two groups.
    UNASSIGNED: The porous-plate Ahmed Glaucoma Valve showed similar average intraocular pressure reduction compared with the silicone-plate model. At 12 months after surgery, there was a significantly lower success rate in the porous-plate compared with the silicone-plate group.
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  • 文章类型: Journal Article
    Alloplastic malar onlays have been used by surgeons to correct or enhance the midfacial skeleton for over 40 years. Case series have shown respectable results using different alloplastic materials in various maxillofacial subsites. However, these articles include small numbers of patients with limited follow up. We present a literature review specifically concentrating on porous polyethylene (Medpor, Stryker) and polyethyl ether ketone (PEEK) malar onlays. We illustrate the technique used by a single oral and maxillofacial surgeon for placement of 119 implants in 61 patients over a 14-year period, and show the results of this work with long-term follow up. A complication rate of 2.5% in this cohort was reported, with follow up of three years, demonstrating that this technique for midfacial correction is successful in both the short and the long term.
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