Modified Turkish delight—“morcellized polyethylene dorsal graft” for rhinoplasty

Object of study: To determine the effectiveness of finely diced medpor (polyethylene) implant material wrapped in surgicel and mixed with 1 ml of the patient’s blood for dorsal augmentation during Rhinoplasty.

Method: We modified the Turkish delight graft by using finely diced chips of high density porous polyethylene (medpor) implant material within the oxidized cellulose (surgicel) mesh and used it for dorsal augmentation. We have found this procedure to be quite satisfactory with respect to its feasibility and effectiveness. Also, patient compliance is more due to the reduction of a second surgical site and its associated complications. It was used on 24 patients over a one year follow up.

Results: We have had satisfactory results so far with this technique. We have used it in cosmetic as well as cleft rhinoplasties. It has a distinct advantage over strut grafting using medpor. In our experience, the strut has to be properly and precisely shaped to achieve good results and still carries the risk of being perceptible after tissue resolution. However, modified Turkish delight when used on the dorsum can even be molded after 3 weeks and hence minor modifications of contour are possible post-operatively. Hence, there is ease of operating while using morcellized medpor graft. Also we have not encountered any significant complication with this technique. A minor complication in a single patient was slight tenderness on the dorsum while wearing spectacles. On palpation, we felt a small nodule which we thought was a medpor particle which must have broken off from the morcellized graft. The patient was given an antibiotic challenge and advised avoiding the use of spectacles for a week and was advised re-exploration in case the symptoms did not subside. However, the patient was lost to follow-up. This complication can be easily avoided by delineating and limiting the boundaries of the surgical pocket. So also, while placing the modified Turkish delight graft, care should be taken to maintain the integrity of the surgicel and avoiding any loose pieces from spreading out of the surgicel. We have not encountered any other significant complication.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Modified Turkish delight—“morcellized polyethylene dorsal graft” for rhinoplasty
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