FRONTOTEMPORAL RECONSTRUCTION USING VARIOUS MATERIALS

ABSTRACT

Based on our experience with 23 frontotemporal reconstructions performed, this paper attempts to provide guidelines for appropriate selection among the four most commonly employed materials (e.g., autogenous parietal bone, silicone rubber, methylmethacrylate, and porous polyethylene) so that optimal results can be achieved. Clinical follow-up ranged from 6 to 91 months (mean 32 months). Every patient was analyzed clinically by ordinary scale method. The mean defect size was 134.8 cm2 in the silicone rubber, 36.5 cm2 in the methylmethacrylate, 17.4 cm2 in the autogenous bone graft and 7.3 cm2 in the porous polyethylene. The clinical assessment was excellent (mean, 29.3 points) in silicone rubber, excellent (mean, 28.6 points) in autogenous bone, excellent (mean, 26.8 points) in methylmethacrylate, and good (mean, 24.8 points) in polyethylene. To sum up, a large bony defect of congenital calvarial anomaly produced an excellent result using custom-made silicone implant. A relatively small bony defect with a scarred bed produced an excellent result using autogenous parietal bone grafting. Unexpected and medium-sized defect was reconstructed successfully through a simple procedure using methylmethacrylate. Porous Polyethylene was used at an incidental small defect because of its expensiveness.