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John L. Frodel, MD; Seung Lee, MD

Arch Otolaryngol Head Neck Surg. 1998;124:1219-1223.

Objective  To determine the usefulness of porous high-density polyethylene implants (Medpor) in a variety of facial skeletal deformities and subcutaneous defects, excluding those associated with acute maxillofacial trauma.

Design  Case series.

Setting  Academic tertiary care referral center in Baltimore, Md.

Patients  Thirty-four patients (age range, 20-74 years) with facial deformities requiring skeletal defect reconstruction or augmentation (38 cases), treated between January 1, 1992, and January 1, 1997. Follow-up ranged from 6 months to 40 months.

Main Outcome Measures  Age, type and origin of the deformity treated, type of treatment, and complications.

Results  Types of deformities and defects treated include 7 patients with orbital defects (secondary traumatic or oncologic deformities), 8 with temporal fossa defects, 8 with frontocranial defects, 4 with maxillary or malar defects, 7 with calvarial bone graft donor site defects, 2 with microtia, and 2 with chin deficiency. Forty implants were placed. Complications included implant exposure in 4 patients and inappropriate augmentation in 1 patient (chin implantation).

Conclusions  High-density polyethylene implants offer an excellent alternative to autogenous and other alloplastic materials in reconstruction of many facial defects and deformities. Advantages include its versatility and relatively ideal pore size that allows for excellent soft tissue ingrowth and coverage. Disadvantages include its rigid nature and difficulty in contouring to the surface of complex skeletal structures.

From the Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Md. Dr Frodel is now with the Division of Otolaryngology and Plastic Surgery, Department of Surgery, The University of New Mexico Health Sciences Center, Albuquerque.

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