Excision of a Nasal Dermoid Sinus Cyst via Open Rhinoplasty Approach and Primary Reconstruction Using Tutoplast-Processed Fascia Lata

Nasal dermoid sinus cysts are the most common congenital midline nasal lesion, accounting for 1% to 3% of all dermoid cysts, and 4% to 12% of all head and neck dermoids. Selection of the appropriate reconstruction technique, after dermoid resection, is important for treatment. Here we describe the successful management of a case with a nasal dermoid sinus cyst using an open rhinoplasty approach, and primary reconstruction using Tutoplast-processed fascia lata and crushed septal cartilage.

A Case of Infection of Tutoplast-Processed Fascia Lata in Augmentation Rhinoplasty

Numerous materials have been used in augmentation rhinoplasty. The representative materials include silastics, Gore-Tex, autologous cartilage, and homologous materials. The use of alloplastic materials in rhinoplasty is often discouraged due to possible risk of infection and extrusion. Currently, the use of Tutoplast-processed fascia lata (TPFL) in augmentation rhinoplasty is increasing in Korea because it can avoid donor site morbidity and decrease the surgical time. However, there have been no reports of infections related to rhinoplasty using TPFL in Korea. We experienced a case of infection that occurred after rhinoplasty using TPFL. We report this case along with a brief review of the literature.

Comparison between the Exposure Rates of Tutoplast(R) and Vicryl Mesh Used as Wrapping Materials for Hydroxyapatite Orbital Implant

PURPOSE: To compare the exposure rates of two wrapping materials for hydroxyapatite (HA) ocular implants (Tutoplast(R) vs. vicryl mesh). METHODS: We reviewed the medical records of 137 eyes of 137 patients who had received intraorbital HA implantation from March 1997 to March 2001. RESULTS: We used Tutoplast(R) in 72 patients and vicryl mesh in 65 patients. The mean follow-up period was 22.1 months. Implant exposure developed in four cases of eyes using vicryl mesh. No case of exposure occurred in eyes using Tutoplast(R). The mean period from operation and implant exposure was 3.5 weeks (1.5~5 weeks). CONCLUSIONS: When vicryl mesh was used as the wrapping material for HA intraorbital implant it is advisable to pay more attention to the possible postoperative implant exposure than when Tutoplast(R) was used.

Bladder Cellular Regeneration after Augmentation Cystoplasty with Human Dura Mater (Tutoplast(R)) in Rat / 대한비뇨기과학회지

PURPOSE: To study the cellular events occuring during bladder development and regeneration, we used the human Dura mater (Tutoplast(R)) for augmenting the rat bladder. We compared their intravesical threshold pressure and volume, and observed the regenerative capacity of urothelium and smooth muscle cell within Tutoplast(R). MATERIALS AND METHODS: Among a total of 67 rats, 11 normal rats were checked their intravesical threshold pressure and volume(Group 1). 9 rats underwent only vesicotomy(Sham operation) and were checked their threshold pressure and volume at 2 months and 3 months postoperatively(Group 2). 47 rats underwent augmentation cystoplasty with Tutoplast(R) after partial cystectomy, which were checked pressure and volume at 1 day, 3-7 days, 2-4 weeks, 2-6 months postoperatively(Group 3). Specimens were examined histologically to assess the regeneration of urothelium and smooth muscle cell on the graft. RESULTS: There was a significant increase in intravesical volume of group 3 compared with group 1 and 2. There was a significant decrease in intravesical pressure of group 3 compared with group 2, but there was no significant difference between group 1 and 3. The specimens of 1 day postopratively showed inflammatory findings. Epithelialization on the graft margin was noted at 3 days postoperatively. At 7 days postoperatively, there was epithelial hyperplasia on the graft site. At 2 weeks postoperatively, there was a partial absorption of Tutoplast(R) as well as favorable progression of epithelialization. Smooth muscle regeneration and complete epithelialization were shown at 3 months postoperatively and absorption of Tutoplast(R) was completed thereafter. CONCLUSIONS: The regeneration of bladder cellular constituents within Tutoplast(R) will be valuable for further understanding the mechanism controlling bladder development and regeneration. Further studies will be necessary for using this method as an alternative strategy to the classical bladder augmentation.

Revision Arthroplasty using Thtoplast - HA Composites for Acetabular Bone Deficiencies / 대한정형외과학회잡지

Sixty-eight revisions of total hip arthroplasties from sixty-one patients were performed using allogenic cancellous chip bone and fine granules of HA for bone deficiencies of the acetabulum at two hospitals in Seoul since September 1992. In our practice, acetabular deficiencies were classified into two broad categories, which were based on our provisional treatment protocol. For the segmental deficiencies of the acetabulum, we employed the method of using the cemented acetabular component. In the mean time, Ling technique of impaction graft with PMMA cement were also employed. For the cavitary deficiencies of the acetabulum, we used several types of uncemented ingrowth cups with HA granules and Tutoplast was used to further ameliorate the bony integration. In addition, we obtained good results in cavitary deficiencies of the acetabulum with C.L.S. Expansion Cup and Ringloc fin Cups which seem that initial stability during the cup installation were remarkable. Unfortunately, we had 5 cases of clinical failure, which consist of bone graft incorporation, where eventual resorption of the graft and implant migration were resulted. Nevertheless electromicroscopic finding of interface taken from failure showed partial new trabecular formation and physicochemical bonding near the host bone bed in some cases. Although primary stability of reconstructive surgery was acceptable, Tutoplast - HA granule composites have similar effect of incorporation to host bone compared with other method of allogenic bonegraft storage, which remodeled after 5 years. Thus, this phenomenon requires further investigation of molecular biological role of tissue substance known as cytokine, as well as microscopic histology.

A Comparative Study of Autograft and Tutoplast Processed Allograft in Posterolateral Lumbar Spine Fusion / 대한정형외과학회잡지

Fresh autogenous bone is regarded as the most effective biologic resource for repair or reconstruction of the skeletal system. Disadvantages, however, are related to doner site morbidity and include the risk of wound infection, increased blood loss, prolonged anesthesia time, and additional postoperative discomfort. To avoid the disadvantages of fresh autogenous bone graft, we started to use Tutoplast processed allograft to the operation of spinal disorders of elderly patients. The purpose of this article is to evaluate the incorporation ability of the allograft and possibility of it for suitable substitutes for autogenous bone graft. From March 1995 to October 1996, twenty-seven elderly patients at Nowon Eulji hospital received operation for mainly stenotic lumbar spine disorders. Surgical procedures to all patients consisted of massive decompression, posterior instrumentation and bilateral posterolateral fusion and were done by same surgeon. The types of bone graft used for 54 cases of posterolateral lumbar spine fusion included 40 cases of autograft alone, 8 cases of Tutoplast processed allograft alone and 6 cases of a combination of autograft and the allograft. Of the 40 cases using the autograft only, 37 cases(92.5%) showed good bone incorporation and fusion mass formation but all eight cases using only Tutoplast processed allograft showed complete resorption within postoperative three to five months. Of the six cases using mixture of autograft and the allograft, three had incomplete but largely appropriate bone mass formation. There was great statistical difference(p<0.001) between autograft and the allograft in bone incorporation ability and concluded that Tutoplast processed allograft was not appropriate for the purpose of solid bone mass formation on posterolateral lumbar spine fusion.