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Porous polyethylene implants are increasingly used for ear reconstruction. Although the material used exhibits good biocompatibility, swelling and edema formation frequently occur after implantation, which may be treated by prophylactic cortisone therapy. The aim of the present study was to analyze the effects of cortisone therapy on the postoperative healing process. PATIENTS AND
Between 2006 and 2010 porous polyethylene implants (Medpor®) were used for ear reconstruction of high-grade ear deformities in 23 patients (m:f=11:12; age: 17.2±12.4 years). For this purpose, 11 patients were treated systemically with cortisone (3 mg/kg body weight Solu-Decortin H) for the first 3 postoperative days, whereas 12 patients (controls) did not receive cortisone. Postoperatively, we analyzed the time course of edema formation, complications and the reconstructive result.
Rejection or extrusion of the polyethylene implants was not observed in any of the patients (n=23) during a postoperative observation period of up to 3.5 years. Within 3-12 months after ear reconstruction all patients exhibited a completely shaped ear. Administration of cortisone had no significant effect on postoperative edema formation or the reconstructive end result.
Porous polyethylene implants are well suited for the reconstruction of moderate to high-grade ear deformities. Since administration of cortisone does not significantly affect the postoperative healing process, prophylactic cortisone treatment following ear reconstruction with porous polyethylene implants should be omitted with regard to potential side effects.
Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum des Saarlandes, Kirrbergerstraße, 66421, Homburg/Saar, Deutschland, firstname.lastname@example.org.
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Polymer of polytetrafluoroethylene and carbon filaments; porous biocompatible material used in orofacial and middle ear reconstruction and as coating for metal implants.
A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses.
Condition of having pores or open spaces. This often refers to bones, bone implants, or bone cements, but can refer to the porous state of any solid substance.
An enzyme that catalyzes the interconversion of a ketone and hydroxy group at C-20 of cortisone and other 17,20,21-trihydroxy steroids. EC 126.96.36.199.
A naturally occurring glucocorticoid. It has been used in replacement therapy for adrenal insufficiency and as an anti-inflammatory agent. Cortisone itself is inactive. It is converted in the liver to the active metabolite HYDROCORTISONE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p726)