gms | German Medical Science

77th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

24.05. - 28.05.2006, Mannheim

Fremdkörperreaktion auf resorbierbares Osteosynthesematerial

Foreign body reaction to resorbable osteosynthesis devices - a case report

Meeting Abstract

  • corresponding author presenting/speaker A. Thiele - Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Halle / Saale, Germany
  • U. Bilkenroth - Institute for Pathology, Martin-Luther-University Halle-Wittenberg, Halle / Saale, Germany
  • M. Bloching - Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Halle / Saale, Germany
  • St. Knipping - Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Halle / Saale, Germany

German Society of Otorhinolaryngology, Head and Neck Surgery. 77th Annual Meeting of the German Society of Otorhinolaryngology, Head and Neck Surgery. Mannheim, 24.-28.05.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06hno085

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2006/06hno085.shtml

Published: September 7, 2006

© 2006 Thiele et al.
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Outline

Text

Introduction: Usually metal osteosynthesis material is used for fixation of centrolateral midfacial fractures. In the 1990th copolymers of poly L-lactic acid (PLLA) and polyglycolic acid (PGA) were introduced as bioresorbable fixation devices. The product information promises high stability, prolonged degradation time and simultaneously excellent biocompatibility.

Case: In 2003 a young man with a right sided centrolateral midfacial fracture was treated surgically in our clinic. After open reposition the fractured lateral orbital margin was fixed using a PLLA-PGA plate and screws. Twenty-two month later this patient consulted us again complaining of a cosmetically disturbing, palpable mass and intermittent pain in the right lateral orbital region.

Results: The surgical exploration showed a solid whitish tumour in this area. After complete excision it was examined histopathologically. Microscopically a granulating cicatricial process with typical signs of a foreign body reaction to the implanted resorbable material was found.

Discussion: In literature foreign body reactions to PLLA-PGA osteosynthesis devices are described in 0-47%. According to the product information of the manufactures these are rare events.

For differential diagnosis of such complains one have to think of dislocated fragments, hypertrophic bony callus and osteolytic tumour. In the presented case this could be excluded.

Conclusion: When utilizing resorbable osteosynthesis materials on PLLA-PGA basis one must be aware of the specific risk of foreign body reactions especially in cosmetically outstanding locations. About this fact and its consequences the patient has to be informed strictly preoperatively.


References

1.
Böstman O, Pihlajamäki H. Adverse tissue reactions to bioabsorbable fixation devices. Clin Orthop Relat Res. 2000, 371, 216-227
2.
Enislidis G, Lagogiannis G, Wittwer G, Glaser C, Ewers R. Fixation of zygomatic fractures with a biodegradable copolymer osteosynthesis system: short- and long-term results. J Oral Maxillofac Surg. 2005, 34, 19-26