Transcript PolyBone
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
on craniofacial area
of
PolyBone
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
Bone Setting CT
X-Ray & 3-D CT
Closure of Oro-Antral Fistula
Closure of Frontal Sinus Opening
Closure of Frontal Sinus Opening
Augmentation of temporal area to
compensate delayed temporal M. atrophy
MVD Op
Obliteration of Sella Floor after
Trans-Sphenoidal Approach
Clinical Application
of
PolyBone
(Aneurysm Cases)
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, K H
PARK S D (M/53)
A-com Aneurysm
MCA Aneurysm
PARK Y J (F/65)
MCA Aneurysm
PARK Y J
SIN Y S (F/49)
ICA bifurcation
Aneurysm
SIN J H (F/74)
P-com Aneurysm
SIN J H
JANG M J (F/58)
MCA Aneurysm
JANG S S (F/67)
MCA Aneurysm
A-com Aneurysm
JANG S S
JANG J Y (F/70)
P-com Aneurysm
JEON M J (F/54)
MCA Aneurysm
JEON M J
JEON Y J (F/66)
Lt. MCA Aneurysm
Rt. P-com Aneurysm
Lt. MCA An. OP
JEON Y J
Post- 2nd Op.
Not repaired on
Rt. side
HAN S H (F/68)
Pericallosal Aneurysm
Well developed Frontal
sinus
Obliteration of opening
of the frontal sinus
HWANG Y H (M/43)
MCA Aneurysm
Impact Block type
Polybone in Pterion
burr hole site
HWANG Y H
YOON M Y (F/60)
A-com Aneurysm