Porous Polyethylene(Medpor?) Implant를 이용한 두개안면 성형술

문정환,정호윤,양정덕,김상우,이동걸,조병채 대한성형외과학회 2004 Archives of Plastic Surgery Vol.31 No.4

Among the alloplastic implants, porous polyethylene (Medpor?) is one of the ideal materials for augmentation of the craniofacial region. The interconnecting open pore structure of Medpor?? allows for tissue ingrowth which promotes host integration and prevents migration. The firm nature allows easy carving and prevents collapsing. Because of these advantages, Medpor?? has been well used for reconstruction of orbital wall.From March 1994 to December 2002, 27 patients were performed the craniofacial contouring surgery using Medpor??. Thirteen patients were male, 14 were female. The causes of operations were as follows: trauma, 16; cosmetic, 8; and others, 3. The sites of implant were as follows: frontal, 8; temporoparietal, 6; zygoma, 5; maxilla, 3; mandible, 3; and periorbital, 2. The follow up period was 6 months to 48 months with an average of 12 months.The implants were placed into the subperiosteal plane, and fixed with titanium screws. After fixation, the final contouring was performed by carving with a knife or shaving with a high speed bur.There was no infection. All implants were in place, and there was no extrusion. All patients were satisfied at the results of the operation. The irregular margin of implant was felt in 3 cases. However, reoperation was not performed in these patients because of minimal irregularity.In conclusion, Medpor?? allows ingrowth of soft tissue without adverse tissue response, and there is no donor mobidity. Implanted Medpor?? were not absorbed or distorted. With these advantages, Medpor?? could be one of ideal implants for craniofacial contouring.

다공성 안와충전물에서 혈관생성 및 유지에 대한 혈관전구세포와 섬유소의 역할

양재욱,이호영,박세광,양영일.Jae Wook Yang. M.D.. Ph.D.. Ho Young Lee. M.D.. Sae Gwang Park. M.D.. Ph.D.. Young Il Yang. M.D.. Ph.D. 대한안과학회 2008 대한안과학회지 Vol.49 No.7

Purpose: The effects of endothelial progenitor cells (EPCs) and fibrin on fibrovascular growth into porous polyethylene orbital implants (Medpor® sheet) were investigated using stem cells. Methods: EPCs were separated from human adipose fat tissue for culture. Fluorescence-activated cell sorting (FACS) was used to identify the phenotype and to analyze the purity of EPCs cultivated from human adipose tissue. Processed Medpor® sheets were inserted in each quadrant of the subcutaneous fat layer under the dorsal surface of 20 anesthetized athymic nude mice, using sterile methods. Medpor® sheets processed with endothelial progenitor cells and fibrin were inserted into the two top quadrants, a Medpor® sheet processed with fibrin was inserted in the lower right quadrant, and an unprocessed Medpor® sheet was inserted in the lower left quadrant of each mouse. The mice were sacrificed on the seventh day. The adhesiveness and blood vessel formation were quantified by weight and the number of blood cells within the Medpor® sheets. Hematoxylin and eosin (H&E) and toluidine blue stains were used to analyze fibrovascular and cell growth within the Medpor® sheets. Results: The sheets processed with EPCs and fibrin were heavier and contained more white and red blood cells (p<0.001) than the other sheets. The sheets processed with fibrin alone were heavier (p<0.01) and contained more blood cells (p<0.001) than the unprocessed sheets. The degree of vessel formation and tissue adhesiveness was greatest in the group of Medpor® sheets processed with EPCs and fibrin. The sheets processed with fibrin only had greater tissue adhesiveness and fibrovascular proliferation than the unprocessed Medpor® sheets. Conclusions: Endothelial progenitor cells and fibrin applied to Medpor® sheets improve fibrovascular proliferation and tissue adhesiveness. When both are applied together, a synergistic effect is seen. J Korean Ophthalmol Soc 49(7):1135-1145, 2008

한국인에서 Medpor를 이용한 비주지주 술식의 유용성

최윤석,윤석영,장태영 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.9

Background and Objectives:Nasal tip plasty is a dificult procedure especially in Koreans who have a thick skin, abundant sub-cutaneous tisue and weak cartilage. Columela strut using autologus cartip supporting procedure, is frequently used in Koreans. Autologus graft material suply is often limited and harvesting entails aditional morbidity. So, the purpose of this study is to investigate the usefulnes of Medpor as columella strut material and its complication. Subjects and Method:We studied 38 patients who underwent nasal tip plasty. Case group (n= 19) underwent tip plasty using Medpor as columela strut material. However, the other group (n= 19)The result of surgery was evaluated on the basis of pre-operative, one and twelve months post-operative photographic analyses. All results were statistically analyzed. Results:Tip projection was 10.3% in the Medpor used group, 5.8% in the cartilage used group at one month after surgery. Tip projection were 8.7% and 4.4% in each group at twelve months after surgery. The degree of tip cephalic rotation was 10.1 degre for the Medpor used cases, and 5.3 degres for cartilage used cases at 1 month after surgery. f tip projection and tip rotation was measured 1.9% and 1.2 degrees in the Medpor used group and 2.4% and 2.1 degrees in the cartilage used group. There was only one case of complication;the extrusion of Medpor into the nasal cavity. Conclusion:Med-por can be a good substitute for columella strut material for Koreans who have weak and small amount of cartilages. (Korean J Otorhinolaryngol-Head Neck Surg 2007 ;50 :773-8)

가토의 안와 하벽에 삽입된 Medpor?의 Barrier Sheet 유무에 따른 유착여부의 비교관찰

김형수,유용아,우종설,이기호,강낙헌 대한성형외과학회 2004 Archives of Plastic Surgery Vol.31 No.5

The purpose of this study was to determine the histopathologic change of Medpor implant for the case of orbital floor reconstruction in the rabbit model.Two types of Medpor(barrier sheet and nonbarrier sheet) were used for the reconstruction of orbital floor in 30 rabbits. In 1 month and 6 months postoperatively, the histopathologic changes were observed with light microscope and forced duction test was performed.None of the implants were lost or extruded and there was no evidence of wound infection, hematoma, or seroma formation. None of cases showed positive in force duction test. Orbital tissue ingrowth was not observed in the barrier sheet Medpor implant group, however, it was observed in the nonbarrier sheet Medpor implant group.This study supports that the barrier sheet Medpor may more suitable than nonbarrier sheet Medpor for reconstruction of the fractured orbital wall.

눈꺼풀판 대용물로 다공성 폴리에틸렌판을 이용한 중앙이마피판 눈꺼풀 재건술

장지혜,장성동 대한안과학회 2009 대한안과학회지 Vol.50 No.7

목적: 위눈꺼풀의 편평상피세포암 환자에서 종양 제거 후 발생한 눈꺼풀 전층 결손을 재건하기 위해 눈꺼풀판 대용으로 MedporⓇ sheet을 이용한 중앙이마피판 눈꺼풀 재건술을 시행한 예를 보고하고자 한다. 증례요약: 55세 여자 환자가 우안 위눈꺼풀의 재발성 종양을 주소로 내원하였다. 동결조직생검상 악성이 판정되어 병변의 수술적 절제 와 눈꺼풀 재건술을 시행하였다. 피부와 근육의 재건을 위해 중앙이마피판을, 눈꺼풀판의 대용물로 MedporⓇ sheet를, 뒤층판 재건에 하안검 결막피판을 사용하였다. 병리조직검사에서 편평상피세포암으로 진단되었고, 수술 2주 후에 뒷층판 결막피판을 분리하고, 8주 후에 이마피판을 위눈꺼풀에서 분리하였다. 술 후 1년 이상 추적 관찰한 결과, 수술 병변은 매우 깨끗하였고, MedporⓇ sheet 노출도 없었다. 눈꺼풀의 형태도 잘 유지되고, 눈 깜박임도 자연스러웠다. 결론: 위눈꺼풀 종양의 광범위한 절제로 인한 눈꺼풀 결손이 클 경우, 눈꺼풀판의 대체 재료로 MedporⓇ sheet 을 사용한 눈꺼풀 재건 술은 미용적으로나 기능적으로 만족한 결과를 보여준다. Purpose: To report the upper eyelid reconstruction with median forehead flap and MedporⓇ sheet implant following fullthickness eyelid defect resulting from tumor resection. Case Summary: A 65-year-old woman was examined at our hospital for a recurrent mass on the right upper eyelid. A wide tumor excision with a 3 mm margin and an eyelid reconstruction procedure were performed after a frozen section biopsy revealed a malignancy. The full-thickness eyelid defect was reconstructed with a median forehead flap as a substitute for skin and muscle and a MedporⓇ sheet substituted for tarsal plate was sutured with a lower conjunctiva flap for posterior lamella. The histopathology diagnosis of the lesion showed a well-differentiated squamous cell carcinoma. The lower conjunctiva was separated at 2 weeks after surgery, and then the median forehead flap detached from the upper eyelid skin at 8 weeks after surgery. One year postoperatively, there was no evidence of a wound infection and an exposure of the MedporⓇ sheet. The eyelid had a good cosmetic contour and the movement of the eyelid during blinking was natural. Conclusions: The use of a MedporⓇ sheet as a substitute for a tarsal plate in reconstructive procedures of the upper eyelid defect shows cosmetic and functional success.

Unfavorable outcome of a paranasal cosmetic prosthesis caused by dental implants: a case report

Jo Hyunmi,Oh Yeonjin,Jeong Bong-Jin,Jung Junho,Ohe Joo-Young 대한치과이식(임프란트)학회 2020 The Korean Academy of Implant Dentistry Vol.39 No.3

This article presents an unfavorable outcome of a paranasal cosmetic prosthesis, Medpor, which is affected by dental implants. The paper provides treatment insight for oral and maxillofacial specialists. The patients had undergone mandibular set-back surgery combined with both paranasal augmentations using Medpor. In due course, dental implants were placed on the anterior maxilla a few years later. The patient suffered from persistent pain and purulent discharge, but no significant correlation was observed on the panorama and CBCT. Dental implants were inserted near the Medpor for a paranasal augmentation, affecting each other, resulting in clinical symptoms. Medpor, as a radiolucent material, was not visible on dental radiography. Its characteristics of a bony-like texture and color could mislead dentists to misjudge a bony structure clinically. Therefore, the dental implant fixtures were inserted near the Medpor. The Medpors on the affected area were infected, requiring it to be surgically removed. This suggests that both dental implants and Medpors failed. A comprehensive evaluation of patient history and strategic presurgical planning should be obtained to avoid an inappropriate consequence of grafting.

흡수성과 비흡수성 안와 내 삽입물을 이용한 안와 내벽골절 수술결과: 비교 연구

김민경,장선영,최혜선,Min Kyung Kim,Sun Young Jang,Hye Sun Choi 대한안과학회 2014 대한안과학회지 Vol.55 No.5

Purpose: To compare the surgical results and complications of medial wall fracture reconstruction using non-absorbable porous polyethylene implants (Medpor<sup>®, Stryker Instruments, Kalamazoo, Michigan, USA) and an absorbable polymer of polyglycolic acid (PGA) and polylactic acid (PLA) (Mesh plate<sup>®, Inion Ltd, Tampere, Finland). Methods: We retrospectively reviewed the data of patients who underwent reconstruction of medial wall fracture between January 2007 and June 2012 and divided them into 2 groups according to orbital implant type (Medpor<sup>®, Mesh plate<sup>®). Results: Among the 86 patients, 37 were treated with Medpor<sup>® and 49 with Mesh plate<sup>®. There was no statistically significant difference in limitation of motion or diplopia score between the 2 groups at postoperative 6 months (Fisher's exact test,<em> p</em> = 0.192, <em>p</em> = 0.128, respectively). Mean postoperative exophthalmometry differences between the eyes were 0.49 ± 1.04 mm and 0.37 ± 0.62 mm in Medpor<sup>® and Mesh plate<sup>® groups, respectively, showing no statistically significant difference (independent t-test, <em>p</em> = 0.512). Postoperative complications such as inflammation or implant malposition were observed only in 3 patients in the Medpor<sup>® group. Conclusions: No difference was observed between Medpor<sup>® and Mesh plate<sup>® in terms of surgical results during the postoperative 6 month period after reconstruction of orbital medial wall fracture. However, postoperative complications were observed in 3 patients in the Medpor<sup>® group. J Korean Ophthalmol Soc 2014;55(5):640-645

눈꺼풀 재건 시 눈꺼풀판의 대용물로 다공성 폴리에틸렌판을 사용한 2예

윤헌주,김시정,윤성욱,윤영선 대한안과학회 2009 대한안과학회지 Vol.50 No.7

Purpose: To report a simple surgical technique for rebuilding the palpebral tarsal plate using a MedporⓇ sheet. The formation of a palpebral tarsal plate is very important in the reconstruction of the eyelid. Transplantation of cartilaginous tissue is often necessary to create the palpebral tarsal plate. However obtaining enough cartilaginous tissue is difficult. Case summary: Eyelid reconstruction and surgical resection of each lesion was attempted on two patients clinically diagnosed with basal cell carcinoma and sebaceous gland carcinoma between August, 2006 and November, 2007. Reconstruction was performed using a modified Cutler-Beard method or the sebaceous gland carcinoma that occurred in the upper eyelid, and a modified Tenzel semicircular rotational flap procedure was used or the basal cell carcinoma that occurred in the lower eyelid. For the reconstruction of tarsus, 0.45 mm MedporⓇ sheet was used. Complications, such as shortage of eyelid movement, dragging of eyelid or unstable eyelid margin, did not occur after the operations in either subject. In the case of the upper eyelid reconstruction, the eyelid became stiff at the early stage, but the condition improved after 6 months. Conclusions: The reconstruction of the palpebral tarsal plate using a MedporⓇ sheet is considered an effective and safe technique for the reconstruction of an eyelid. 목적: 눈꺼풀 재건술에 있어서 눈꺼풀판의 형성이 매우 중요하다. 흔히 자가 연골성분의 이식이 눈꺼풀판 재건에 필요하지만 충분한 양을 얻기가 힘들 수 있다. 이에 저자들은 눈꺼풀판의 대용물로 MedporⓇ sheet를 사용한 증례가 있어 이를 보고하고자한다. 증례요약: 2006년 8월부터 2007년 11월까지 임상적으로 바닥세포암과 피지샘암으로 진단된 2명을 대상으로 각각 병변의 수술적 절제와 더불어 눈꺼풀의 재건을 시도하였다. 윗눈꺼풀에 발생한 피지샘암의 경우 변형된 교량 피판수술법을, 그리고 아래 눈꺼풀에 발생한 바닥세포암의 경우는 변형된 Tenzel의 반원형 회전 피판법을 사용하여 재건하였다. 이 때 눈꺼풀판의 재건에는 0.45 mm MedporⓇ sheet를 사용하였다. 대상 모두에서 수술 후 눈꺼풀의 움직임 부족, 눈꺼풀 뒤당김, 불안정한 눈꺼풀테 등의 합병증은 발생하지 않았으며, 윗눈꺼풀 재건술의 경우 술 후 초기에 나타난 눈꺼풀의 뻣뻣함의 경우도 6개월이 경과한 후부터는 보다 자연스러워진 상태를 보였다. 결론: 눈꺼풀을 재건하는데 있어 눈꺼풀판의 대용물로 MedporⓇ sheet를 사용한 수술법은 효과적이고 안전한 치료방법 중 하나라고 생각된다.

다공성 폴리에틸렌 안와충전물(Medpor®)의 노출시 진피-지방 이식술을 통한 치료 4례

최희영 釜山醫師會 2001 釜山醫師會誌 Vol.37 No.8

두개안면골 재건 및 미용분야에 있어서의 고밀도 폴리에틸렌(Medpor)의 사용

이동은,김용하,설정현 대한미용성형외과학회 1998 Archives of Aesthetic Plastic Surgery Vol.4 No.1