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[Healing process of cartilage attached to a polydioxanone implant]
Background And Objective:
To correct severe septal deformities, it is often necessary to perform an extracorporal septoplasty with temporary removal of the deviated septal cartilage, followed by straightening and reimplantation into the nose as free graft. The utilization of a compound graft, which sutures the cartilage fragments to a resorbable polydioxanon (PDS) foil, facilitates this technique immediately while simultaneously ensuring support of the nasal dorsum.
Patients/Methods:
On account of the good clinical experiences (during the past 3 years 71 patients have been treated using this method), we investigated the biological properties of the foil and its degradation products in connection with cartilage in an animal model from a histological point of view. In five rabbits, a 0.15-mm-thick PDS foil was implanted in combination with the cartilage into the outer ear. The follow-up period was between 2 and 25 weeks.
Results:
The results showed the following: (1) Up to the tenth week, the foil maintains the original structure; (2) The foil will be completely resorbed after 25 weeks; (3) The cartilage underneath the foil is protected from necrosis; (4) The degradation products of the polydioxanon do not interfere with the healing process; (5) Concerning the regeneration of cartilage, the foil acts as a guarding splint; (6) After resorption, almost no scar tissue remains.
Conclusions:
Due to the fact that the PDS foil endonasal implant means no additional risk to the patient, we can recommend the compound graft for simplification of extracorporal septoplasty.