Septorhinoplasty for Destructed Septal L-Strut in Patients with Previously Applied Porous High-Density Polyethylene Implants (Medpor ® )

Kyung Chul Moon, Jae Eun Jung, Eun-Sang Dhong, Seong-Ho Jeong, Seung-Kyu Han

Research output: Contribution to journalArticle

Abstract

Background: Porous high-density polyethylene implants (Medpor ® ) have been extensively used for septal extension grafts in Asian rhinoplasty. However, studies on the long-term complications associated with Medpor ® have not been reported. Therefore, the purpose of this study was to evaluate the long-term complications of septal extension grafts using Medpor ® and present a reconstructive strategy for destructed septal L-struts. Methods: We conducted a 12-year retrospective medical chart review of 428 patients who visited our center for septorhinoplasty. Among 428 patients, 43 patients had Medpor ® for septal extension grafts previously applied at other clinics. The quadrangular cartilage was devoid or destructed in the area where Medpor ® was previously applied. Therefore, all patients underwent secondary septorhinoplasty using autogenous cartilage grafts. Patient outcome was assessed to evaluate satisfaction, hardness of nasal tip, functional nasal obstruction symptom evaluation (NOSE) scores, and pain scores. Anthropometric analyses were carried out with patients’ photographs. Postoperative complications were also evaluated. Results: After septal L-strut reconstruction, 87% of patients were satisfied with their aesthetic results. Hardness of nasal tip, NOSE scores, and pain scores also improved after reconstruction. Anthropometric analyses demonstrated that increased nasal length and decreased columellar–labial angle were achieved in patients with short nose deformities. No postoperative complications related to the reconstruction were recorded for any patient. Conclusions: The devastated destruction of nasal support lines was found after the use of Medpor ® for septorhinoplasty. Therefore, the use of Medpor ® should be reduced. Autogenous cartilage grafts are the last resort for reconstruction of destructed septal L-struts. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Original languageEnglish
JournalAesthetic Plastic Surgery
DOIs
Publication statusPublished - 2019 Jan 1

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Polyethylene
Nose
Transplants
Cartilage
Nasal Obstruction
Symptom Assessment
Hardness
Medpor
Pain
Rhinoplasty
Evidence-Based Medicine
Esthetics

Keywords

  • Complication
  • Destruction
  • Medpor
  • Reconstruction
  • Septorhinoplasty

ASJC Scopus subject areas

  • Surgery

Cite this

@article{352ea5726dfb4dd1a3849e2ac740b002,
title = "Septorhinoplasty for Destructed Septal L-Strut in Patients with Previously Applied Porous High-Density Polyethylene Implants (Medpor {\circledR} )",
abstract = "Background: Porous high-density polyethylene implants (Medpor {\circledR} ) have been extensively used for septal extension grafts in Asian rhinoplasty. However, studies on the long-term complications associated with Medpor {\circledR} have not been reported. Therefore, the purpose of this study was to evaluate the long-term complications of septal extension grafts using Medpor {\circledR} and present a reconstructive strategy for destructed septal L-struts. Methods: We conducted a 12-year retrospective medical chart review of 428 patients who visited our center for septorhinoplasty. Among 428 patients, 43 patients had Medpor {\circledR} for septal extension grafts previously applied at other clinics. The quadrangular cartilage was devoid or destructed in the area where Medpor {\circledR} was previously applied. Therefore, all patients underwent secondary septorhinoplasty using autogenous cartilage grafts. Patient outcome was assessed to evaluate satisfaction, hardness of nasal tip, functional nasal obstruction symptom evaluation (NOSE) scores, and pain scores. Anthropometric analyses were carried out with patients’ photographs. Postoperative complications were also evaluated. Results: After septal L-strut reconstruction, 87{\%} of patients were satisfied with their aesthetic results. Hardness of nasal tip, NOSE scores, and pain scores also improved after reconstruction. Anthropometric analyses demonstrated that increased nasal length and decreased columellar–labial angle were achieved in patients with short nose deformities. No postoperative complications related to the reconstruction were recorded for any patient. Conclusions: The devastated destruction of nasal support lines was found after the use of Medpor {\circledR} for septorhinoplasty. Therefore, the use of Medpor {\circledR} should be reduced. Autogenous cartilage grafts are the last resort for reconstruction of destructed septal L-struts. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.",
keywords = "Complication, Destruction, Medpor, Reconstruction, Septorhinoplasty",
author = "Moon, {Kyung Chul} and Jung, {Jae Eun} and Eun-Sang Dhong and Seong-Ho Jeong and Seung-Kyu Han",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00266-019-01386-6",
language = "English",
journal = "Aesthetic Plastic Surgery",
issn = "0364-216X",
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T1 - Septorhinoplasty for Destructed Septal L-Strut in Patients with Previously Applied Porous High-Density Polyethylene Implants (Medpor ® )

AU - Moon, Kyung Chul

AU - Jung, Jae Eun

AU - Dhong, Eun-Sang

AU - Jeong, Seong-Ho

AU - Han, Seung-Kyu

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Porous high-density polyethylene implants (Medpor ® ) have been extensively used for septal extension grafts in Asian rhinoplasty. However, studies on the long-term complications associated with Medpor ® have not been reported. Therefore, the purpose of this study was to evaluate the long-term complications of septal extension grafts using Medpor ® and present a reconstructive strategy for destructed septal L-struts. Methods: We conducted a 12-year retrospective medical chart review of 428 patients who visited our center for septorhinoplasty. Among 428 patients, 43 patients had Medpor ® for septal extension grafts previously applied at other clinics. The quadrangular cartilage was devoid or destructed in the area where Medpor ® was previously applied. Therefore, all patients underwent secondary septorhinoplasty using autogenous cartilage grafts. Patient outcome was assessed to evaluate satisfaction, hardness of nasal tip, functional nasal obstruction symptom evaluation (NOSE) scores, and pain scores. Anthropometric analyses were carried out with patients’ photographs. Postoperative complications were also evaluated. Results: After septal L-strut reconstruction, 87% of patients were satisfied with their aesthetic results. Hardness of nasal tip, NOSE scores, and pain scores also improved after reconstruction. Anthropometric analyses demonstrated that increased nasal length and decreased columellar–labial angle were achieved in patients with short nose deformities. No postoperative complications related to the reconstruction were recorded for any patient. Conclusions: The devastated destruction of nasal support lines was found after the use of Medpor ® for septorhinoplasty. Therefore, the use of Medpor ® should be reduced. Autogenous cartilage grafts are the last resort for reconstruction of destructed septal L-struts. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

AB - Background: Porous high-density polyethylene implants (Medpor ® ) have been extensively used for septal extension grafts in Asian rhinoplasty. However, studies on the long-term complications associated with Medpor ® have not been reported. Therefore, the purpose of this study was to evaluate the long-term complications of septal extension grafts using Medpor ® and present a reconstructive strategy for destructed septal L-struts. Methods: We conducted a 12-year retrospective medical chart review of 428 patients who visited our center for septorhinoplasty. Among 428 patients, 43 patients had Medpor ® for septal extension grafts previously applied at other clinics. The quadrangular cartilage was devoid or destructed in the area where Medpor ® was previously applied. Therefore, all patients underwent secondary septorhinoplasty using autogenous cartilage grafts. Patient outcome was assessed to evaluate satisfaction, hardness of nasal tip, functional nasal obstruction symptom evaluation (NOSE) scores, and pain scores. Anthropometric analyses were carried out with patients’ photographs. Postoperative complications were also evaluated. Results: After septal L-strut reconstruction, 87% of patients were satisfied with their aesthetic results. Hardness of nasal tip, NOSE scores, and pain scores also improved after reconstruction. Anthropometric analyses demonstrated that increased nasal length and decreased columellar–labial angle were achieved in patients with short nose deformities. No postoperative complications related to the reconstruction were recorded for any patient. Conclusions: The devastated destruction of nasal support lines was found after the use of Medpor ® for septorhinoplasty. Therefore, the use of Medpor ® should be reduced. Autogenous cartilage grafts are the last resort for reconstruction of destructed septal L-struts. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

KW - Complication

KW - Destruction

KW - Medpor

KW - Reconstruction

KW - Septorhinoplasty

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