title: A comparison of surgical outcomes with the use of 2 different biodegradable multipoint fixation devices for endoscopic forehead elevation.
abstract: OBJECTIVE
  To assess the efficacy and rates of inflammatory cyst formation with the use of 2 different biodegradable multipoint fixation devices, Endotine versus Ultratine, for endoscopic forehead elevation.
  
  
  METHODS
  The charts of 138 patients who underwent endoscopic forehead elevation by the same surgeon (E.H.B.) were reviewed retrospectively. Data regarding patient demographics, type of biodegradable fixation device, loss of fixation in the immediate and late postoperative period, inflammatory cyst formation of the fixation device, additional complications, and reoperation status were collected from the charts. Patients implanted with Endotine and Ultratine were compared postoperatively for early and late loss of elevation (efficacy), inflammatory cyst formation, additional complications, and reoperation rates.
  
  
  RESULTS
  Of the 276 fixation devices implanted (117 Endotine and 159 Ultratine), 11 inflammatory cysts were found, all of them in the Ultratine group (p = 0.0037). Four patients required reoperation due to early loss of fixation. Three of these cases were in the Endotine group, and 1 case was observed in the Ultratine group (p = 0.18). A total of 4 patients had late loss of fixation, all of them in the Ultratine group (p = 0.08). Scalp hypoesthesia and/or dysesthesia beyond the sixth postoperative month were observed in 3.62% of the cases. Postsurgical neuralgia was observed in 2.17%, and focal alopecia was seen in 1.44%.
  
  
  CONCLUSIONS
  The presence of inflammatory cysts with the implantation of the Ultratine device is statistically higher than with Endotine. No statistical significant difference was found in either early or late fixation loss between the 2 groups.
authors.affiliation: Ophthalmic Plastic, Orbital and Reconstructive Surgery, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan, USA. javierservat@gmail.com
authors.forename: J Javier
authors.initials: JJ
authors.lastname: Servat
authors.forename: Evan H
authors.initials: EH
authors.lastname: Black
mesh_terms: D020341:Absorbable Implants; D004724:Endoscopy; D004814:Epidermal Cyst / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005546:Forehead; D005549:Foreign-Body Reaction / Q000175:diagnosis / Q000209:etiology*; D015743:Giant Cells, Foreign-Body / Q000473:pathology; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology; D013508:Ophthalmologic Surgical Procedures / Q000295:instrumentation*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D015361:Rhytidoplasty; D053831:Surgical Fixation Devices / Q000009:adverse effects*; D016896:Treatment Outcome