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PolyBone. NuroSpine. Cranio-Facial Bone defect. * Trauma * Surgically induced * Cranio-facial bone tumor Awesome to patients & surgeons due to cosmetic problems Esp) pterional approach (bone defect & delayed temporal m. atrophy).
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PolyBone NuroSpine
Cranio-Facial Bone defect • * Trauma * Surgically induced * Cranio-facial bone tumor • Awesome to patients & surgeons due to cosmetic problems Esp) pterional approach (bone defect & delayed temporal m. atrophy)
PMMA(acryl cement, Resin) * Most commonly used in Cranio-Facial defect area. * Advantages 1. Low Price 2. High Mechanical Strength * Disadvantages 1. May Marked Inflammation Response 2. Fibrous Encapsulation of Implant -> Possibility of Infection & loosening of implant
PMMA(acryl cement, Resin) * Disadvantages 3. High temperature (1100 C) generated -> Tissue damage 4. Shaping of Contour of implant after hardening is difficult 5. Never convert to Bone 6. No Bone bonding effect -> Need fixation device (wire, craniofix etc.)
Calcium Phosphate Cement • Advantages: - Biocompatible material - Have bone conduction activity - Easily handling - Good osteointegration - Converted to Bone • Disadvantages: - Low tensile strength than PMMA - Higher cost
PolyBone * Brushite Calcium phosphate Cement(CPC) -> Convert to bone is fast than other CPC * Included Poly-phosphates (Poly-P) : patent -> Poly-P have bone induction activity -> So, PolyBone have both bone induction & conduction activity
PolyBone * BoneSource hardening time: 10-20 mins PolyBone hardening time : within 5 mins * Good Bone bonding effect -> No need of fixation device such as wire or craniofix etc .
PolyBone * Easily making contour during application & after hardening - such as knife, or sharp instrument * Augumentation during the procedure is possible (esp. temporal area)
Tips • If dura was slack down below the inner cortex of bone margin at the bone defect area, put the gelform on the dura at the bone defect area. -> not to compress the brain by PolyBone
Tips • If you anticipated of delayed temporal muscle atrophy, Augmentation of temporal bone area with CPC is possible.
Tips • It is recommended to use each 5 g package separated. • Well adhesion of new CPC to already hardening CPC.
Application of PolyBone on Craniofacial part • Reconstruction of cranial defects -> If larger defect than 10cm2, use of wire mesh is recommended. • Closure of frontal sinus opening • Fronto-temporal contouring (Aneurysm Op.)
Clinical Application Fronto-orbito-zygomatic approach Onlay grafting for augmentation & smoothing contours of skeletal irregularities MVD Op.
Clinical Application • Augumentaion of nasoglabellar, supraorbital rim, mandible • Lateral skull base reconstruction • Translabyrinthine approaches & other skull base approach
Clinical Application All of these are non-stress-bearing areas in craniofacial skeleton
Contraindications of PolyBone Infected field Areas surrounding nonviable bone Abnormal calcium metabolism Metabolic bone diseases Recent untreated infection Poor wound healing Immunologic abnormalities
Augmentation of temporal area to compensate delayed temporal M. atrophy
KIM, K Y (F/55) • Rt. MCA Aneurysm
KIM, J Y (M/69) • Pericallosal Aneurysm
KIM, T J (F/63) • A-com Aneurysm
PARK, K H (F/59) • P-com Aneurysm • MCA Aneurysm
PARK S D (M/53) • A-com Aneurysm • MCA Aneurysm
PARK Y J (F/65) • MCA Aneurysm
SIN Y S (F/49) • ICA bifurcation Aneurysm