title: Safety and Efficacy of Expanded Polytetrafluoroethylene Implants in the Surgical Management of Traumatic Nasal Deformity.
abstract: OBJECTIVE
  The ideal alloplastic implant for correction of traumatic nasal deformity has not been adequately examined.
  
  
  OBJECTIVE
  To evaluate the safety profile and postoperative results of expanded polytetrafluoroethylene (ePTFE) implants used in functional nasal surgery (FNS) in the setting of traumatic nasal deformity.
  
  
  METHODS
  We conducted a 13-year retrospective medical chart review for patients treated at a tertiary academic facial plastic and reconstructive surgery practice between July 1999 and July 2012. A total of 404 FNS procedures were performed by a single surgeon during this period, 255 to repair traumatic deformities, 35 of these involving ePTFE implants. Patient demographics, medical comorbidities, operative and technical considerations, functional and aesthetic results, complications, and postoperative course findings were collected from patient records. In addition, preoperative and postoperative photographic documents were examined.
  
  
  METHODS
  Functional nasal surgery.
  
  
  METHODS
  Postoperative complications or presentations necessitating revision.
  
  
  RESULTS
  A total of 404 patients (197 male, 207 female) underwent FNS. Of those, 255 procedures were to treat traumatic deformities. Forty patients altogether required the use of an ePTFE implant, 35 of those 40 deformities being associated with a traumatic injury. One of the 35 patients in the ePTFE-repaired traumatic deformities group experienced postoperative infection. This patient ultimately developed exposure after the infection failed to resolve with oral antibiotics, and the implant was removed. An additional patient in the ePTFE group required revision of the implant owing to contour irregularity and aesthetic concerns. No infections or other complications occurred among the 220 patients with traumatic deformity treated with autologous grafts. Analysis of other variables including sex, tobacco use, diabetes, immunosuppression, implant thickness, suture material, and prior septorhinoplasty were not associated with increased rate of infection (P > .05 for all).
  
  
  CONCLUSIONS
  In the setting of traumatic nasal deformities requiring FNS, ePTFE implants can be used at the level of the nasal dorsum, where soft tissue coverage is often adequate, with a low risk of complications.
authors.affiliation: Meridian Plastic Surgeons, Private Practice, Indianapolis, Indiana.
authors.forename: Scott
authors.initials: S
authors.lastname: Shadfar
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Alexandar
authors.initials: A
authors.lastname: Farag
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Jarchow
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill.
authors.forename: William W
authors.initials: WW
authors.lastname: Shockley
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009666:Nose / Q000293:injuries*; D009667:Nose Deformities, Acquired / Q000209:etiology* / Q000601:surgery*; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000295:instrumentation*; D016896:Treatment Outcome
chemical_list: D011138:Polytetrafluoroethylene