[Ear reconstruction using porous polyethylene implants. Effect of cortisone on edema reduction and healing process]

Abstract

Introduction: 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 methods: 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.

Results: 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.

Conclusion: 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.