Treatment of exposed hydroxyapatite orbital implants wrapped with a synthetic dura substitute
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Purpose: To describe cases of exposed hydroxyapatite (HA) implants wrapped with the synthetic dura substituteNeuro-Patch treated via simple Neuro-Patch removal. Methods: The medical records of seven patients who experienced exposure of their HA implant were reviewed. All patients had been enucleated and implanted with HA wrapped with Neuro-Patch. For treatment, Neuro-Patch was removed to the greatest extent possible. After applying local anesthesia with lidocaine, bluntdissection was performed to separate the conjunctiva and Neuro-Patch via the site of exposure. Pressure wasapplied to the remaining Neuro-Patch with forceps and removed with scissors. Results: Neuro-Patch was visible at the area of exposure in all patients. No surgery beyond initial Neuro-Patchremoval was necessary in six of the seven patients. In five cases, the exposed area began to heal rapidly afterNeuro-patch removal without primary closure of the defect. In one case, the Neuro-Patch material and allnecrotic tissue was removed aggressively due to inflammation around the orbital implant. Lastly, an infectionwas noted in one case, prompting complete removal of the Neuro-Patch–wrapped HA implant. Conclusions: Wrapping material may hinder implant vascularization. Exposure of HA in wrapped implants canbe successfully treated by a simple removal procedure if detected and managed early.
Abstract
Purpose: To describe cases of exposed hydroxyapatite (HA) implants wrapped with the synthetic dura substituteNeuro-Patch treated via simple Neuro-Patch removal. Methods: The medical records of seven patients who experienced exposure of their HA implant were reviewed. All patients had been enucleated and implanted with HA wrapped with Neuro-Patch. For treatment, Neuro-Patch was removed to the greatest extent possible. After applying local anesthesia with lidocaine, bluntdissection was performed to separate the conjunctiva and Neuro-Patch via the site of exposure. Pressure wasapplied to the remaining Neuro-Patch with forceps and removed with scissors. Results: Neuro-Patch was visible at the area of exposure in all patients. No surgery beyond initial Neuro-Patchremoval was necessary in six of the seven patients. In five cases, the exposed area began to heal rapidly afterNeuro-patch removal without primary closure of the defect. In one case, the Neuro-Patch material and allnecrotic tissue was removed aggressively due to inflammation around the orbital implant. Lastly, an infectionwas noted in one case, prompting complete removal of the Neuro-Patch–wrapped HA implant. Conclusions: Wrapping material may hinder implant vascularization. Exposure of HA in wrapped implants canbe successfully treated by a simple removal procedure if detected and managed early.
참고문헌 (19)
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