A Case of Early Septal Reconstruction with Autogenous Cartilage Graft with Bioaborbable Plate in a 13-Year-Old Male of Nasal Septal Abscess / 대한이비인후과학회지

Nasal septal abscess is a serious condition that necessitates urgent surgical management, and it may lead to saddle nose deformity caused by the loss of cartilaginous support. To date, there is no consensus among clinicians with regard to early versus late surgical management of the saddle nose deformity. For the growing child, reconstructing the septum is essential for the normal development of the nose. We present a case of nasal septal abscess with a nearly total loss of septal cartilage of a 13-year-old male. His nasal septum was reconstructed immediately with autologous ear cartilage attached to a bioabsorbable plate through open approach. The aesthetic problems such as the saddle nose have not occurred during the follow-up period.

Correction of Caudal Septal Deviation: Septal Batten Graft with a Bioabsorbable Plate / 대한이비인후과학회지

Caudal septal deviation is difficult to correct due to elasticity of cartilage. Septal batten graft is a useful surgical technique used for correction of caudal septal deviation and the septal cartilage is used mainly for graft material. However, in some cases (i.e., revision surgery), its quality may be insufficient or inadequate to be useful. Septal batten graft with a bioabsorbable plate can be an alternative in these cases. The use of a bioabsorbable plate connected with septal cartilage would facilitate surgical correction of severe caudal septal deviation and offer mechanical stability until the manipulated cartilage heals. With a brief review of the literature, we describe our experience of treating a 29-year-old woman with severe caudal septal deviation and clinical summary of 7 patients who underwent septal batten graft using a bioabsorbable plate for caudal septal deviation.

Bioabsorbable osteofixation for orthognathic surgery / 대한악안면성형재건외과학회지

Orthognathic surgery requires stable fixation for uneventful healing of osteotomized bony segments and optimal remodeling. Titanium plates and screws have been accepted as the gold standard for rigid fixation in orthognathic surgery. Although titanium osteofixation is the most widely used approach, the use of bioabsorbable devices has been increasing recently. Biodegradation of bioabsorbable devices eliminates the need for a second operation to remove metal plates and screws. However, long-term stability and relapse frequency in bioabsorbable osteofixation are still insufficiently studied, especially in cases of segmental movements of great magnitude or segmental movements to a position where bony resistance exists. This paper reviews the background, techniques, and complications of bioabsorbable osteofixation and compares bioabsorbable and titanium osteofixation in orthognathic surgery in terms of skeletal stability.

Results of Reconstruction of Orbital Wall Fracture With Bioresorbable Plate

PURPOSE: To investigate the long-term results and complications of orbital wall fracture reconstruction using the bioabsorbable orbital implant, Macropore(R) orbital floor liner. METHODS: This retrospective study included patients who underwent the reconstruction of an orbital wall fracture using Macropore(R) orbital floor liner and completed a postoperative follow-up longer than 6 months. The enophthalmic values as well as the data of ocular movement and diplopia was collected from the medical records of each patient and analyzed. RESULTS: A total of 35 patients were evaluated with an average follow-up period of 14.0 months. The average enophthalmic value of 29 patients, whose reconstruction was primarily indicated from enophthalmic tissue, was 0.90 mm at the last follow-up. No significant progression of enophthalmos was observed at postoperative 12, 18 and 24 months when compared with the enophthalmic value at postoperative 6 months. All 15 patients who have had the limitation of ocular movement or diplopia preoperatively resolved completely or improved to the degree that no clinically significant limitation or diplopia further existed. No complications such as dislocation of implant, infection, and aggravation of ocular limitation were observed during the follow-up period. CONCLUSIONS: Macropore(R) orbital floor liner may be regarded as a useful implant in reconstruction of orbital wall fracture with no significant implant-related complications during its absorption.

Fixation of Mandibular Fracture with Bioabsorbable Self-reinforced Poly(L/DL)-lactide(70/30%) Plate and Screw

Metal fixation device, titanium miniplate is commonly used in facial bone fixation. But metal fixation device requires secondary removal procedure because of such complications as bony atrophy, metallic corrosion, low carcinogenic risk, growth disturbance of craniofacial skeleton, and endocranial migration of device which may lead to pediatric craniofacial surgery. Bioabsorbable plates lose strength retention after a given period of time unlike metalic plates, are degraded and absorbed completely in human body. Because they yield no metalic complications nor risks, and require no secondary removal, their use has been recently increased in fixation of facial bone. Self-inforced(SR)-poly(L/DL) lactide(70/30%) plate is applied for the fixation of midfacial bone in adult. But its weak strength brings concern about the skeletal stability, and makes surgeons hesitate its application to mandibular fractures. SR-poly(L/DL) lactide are rarely used especially in mandibular fractures. The authors used Biosorb FX 2.0 plate in 58 patients of mandibular fractures by open reduction and internal fixation. The duration of intermaxillary fixation was 7 days in 12 patients of multiple fractures. Follow-up period was 4 to 16 months(mean; 12 months). Complications included 2 cases with malocclusion, 6 cases with sensory disturbance and no infection was reported. The malocclusion was solved by minimal occlusal grinding, and sensory disturbance was temporary. The authors applied bicortical fixation of two plate system(thickness 1.2mm) with long screws or large diameter screws to mandibular fractures and obtained sufficient skeletal stability. The risk of tissue reaction associated with possible postimplantative crystallization of SR-poly(L/DL) lactide(70/ 30%) could be reduced. They report their experiences with review of literature.

Treatment of Mandible Fractures Using Bioabsorbable Plates: Preliminary Study

This study evaluated the short-term outcome of treating fractures of the mandible with bioabsorbable plates. Thirty-four fractures of the mandible in 27 patients were treated by open reduction and internal fixation using bioabsorbable plates and 2.4-mm, 2.0-mm, and 1.5-mm pre-tapped screws. The duration of intermaxillary fixation ranged from 0 to 23 days, with a mean of 5.3 days. Patients were evaluated for complications during the follow-up period, which ranged from 2 to 18 months. Five patients (18.5%) experienced complications. These included infection (four patients), and premature occlusal contact (one patient). Except for one case, all complications were minor and adequately managed with incision and drainage, elastic traction, and medication. Delayed infection (osteomyelitis) developed in a symphysis fracture and was treated by saucerization and antibiotics. The fracture line subsequently showed complete consolidation. Bioabsorbable plates can be selectively used for internal fixation in mandibular fractures with the advantage that they do not need to be removed.