PolyBonePolyBone
NuroSpineNuroSpine
Cranio-Facial Bone defectCranio-Facial Bone defect
* Trauma* Trauma * Surgically induced* Surgically induced * Cranio-facial bone tumor* Cranio-facial bone tumor
Awesome to patients & surgeons due to Awesome to patients & surgeons due to cosmetic problemscosmetic problems
Esp) pterional approach (bone defect & Esp) pterional approach (bone defect & delayed temporal m. atrophy)delayed temporal m. atrophy)
PMMA(acryl cement, Resin)PMMA(acryl cement, Resin)
** Most commonly used in Cranio-Facial defect area. Most commonly used in Cranio-Facial defect area.
* Advantages* Advantages
1. Low Price1. Low Price
2. High Mechanical Strength2. High Mechanical Strength
* Disadvantages* Disadvantages
1. May Marked Inflammation Response1. May Marked Inflammation Response
2. Fibrous Encapsulation of Implant2. Fibrous Encapsulation of Implant
-> Possibility of Infection & loosening of implant-> Possibility of Infection & loosening of implant
PMMA(acryl cement, Resin)PMMA(acryl cement, Resin)
* Disadvantages* Disadvantages
3. High temperature (1103. High temperature (11000 C) generated C) generated
-> Tissue damage-> Tissue damage
4. Shaping of Contour of implant after 4. Shaping of Contour of implant after
hardening is difficulthardening is difficult
5. Never convert to Bone5. Never convert to Bone
6. No Bone bonding effect6. No Bone bonding effect
-> Need fixation device (wire, craniofix etc.)-> Need fixation device (wire, craniofix etc.)
Calcium Phosphate CementCalcium Phosphate Cement
Advantages:Advantages: - Biocompatible material- Biocompatible material - Have bone conduction activity- Have bone conduction activity - Easily handling- Easily handling - Good osteointegration- Good osteointegration - Converted to Bone- Converted to Bone
Disadvantages:Disadvantages: - Low tensile strength than PMMA- Low tensile strength than PMMA - Higher cost - Higher cost
PolyBonePolyBone
* Brushite Calcium phosphate Cement(CPC) * Brushite Calcium phosphate Cement(CPC)
-> Convert to bone is fast than other CPC -> Convert to bone is fast than other CPC
* Included Poly-phosphates (Poly-P) : patent* Included Poly-phosphates (Poly-P) : patent
-> Poly-P have bone induction activity-> Poly-P have bone induction activity
-> So, -> So, PolyBonePolyBone have both bone induction have both bone induction
& conduction activity& conduction activity
PolyBonePolyBone
* BoneSource hardening time: 10-20 mins* BoneSource hardening time: 10-20 mins
PolyBone hardening time : within 5 mins PolyBone hardening time : within 5 mins
* Good Bone bonding effect* Good Bone bonding effect
-> No need of fixation device -> No need of fixation device
such as wire or craniofix etcsuch as wire or craniofix etc
..
PolyBonePolyBone
* * Easily making contour during Easily making contour during
application & after hardeningapplication & after hardening
- such as knife, or sharp instrument- such as knife, or sharp instrument
* Augumentation during the procedure* Augumentation during the procedure
is possible (esp. temporal area)is possible (esp. temporal area)
TTipsips If dura was slack down below the inner cortex of If dura was slack down below the inner cortex of
bone margin at the bone defect area, put the bone margin at the bone defect area, put the gelform on the dura at the bone defect area.gelform on the dura at the bone defect area.
-> not to compress the brain by PolyBone-> not to compress the brain by PolyBone
TTipsips
If you anticipated of delayed temporal muscle If you anticipated of delayed temporal muscle atrophy, Augmentation of temporal bone area atrophy, Augmentation of temporal bone area with CPC is possible.with CPC is possible.
TTipsips It is recommended to use each 5 g package It is recommended to use each 5 g package
separated. separated. Well adhesion of new CPC to already hardening Well adhesion of new CPC to already hardening
CPC.CPC.
Application of PolyBone on Application of PolyBone on Craniofacial partCraniofacial part
Reconstruction of cranial defectsReconstruction of cranial defects
-> If larger defect than 10cm-> If larger defect than 10cm22, use of wire , use of wire
mesh is recommended.mesh is recommended.
Closure of frontal sinus openingClosure of frontal sinus opening
Fronto-temporal contouring (Aneurysm Op.)Fronto-temporal contouring (Aneurysm Op.)
Clinical Application on craniofacial area
of PolyBone
Fronto-orbito-zygomatic approachFronto-orbito-zygomatic approach
Onlay grafting for augmentation & Onlay grafting for augmentation &
smoothing contours of skeletal smoothing contours of skeletal
irregularitiesirregularities
MVD Op.MVD Op.
Clinical Application
Augumentaion of nasoglabellar, Augumentaion of nasoglabellar,
supraorbital rim, mandiblesupraorbital rim, mandible
Lateral skull base reconstructionLateral skull base reconstruction
Translabyrinthine approaches & other Translabyrinthine approaches & other
skull base approachskull base approach
Clinical Application
All of these are non-stress-bearing All of these are non-stress-bearing
areas in craniofacial skeletonareas in craniofacial skeleton
Clinical Application
Contraindications of PolyBoneContraindications of PolyBone
Infected fieldInfected field Areas surrounding nonviable boneAreas surrounding nonviable bone Abnormal calcium metabolismAbnormal calcium metabolism Metabolic bone diseasesMetabolic bone diseases Recent untreated infectionRecent untreated infection Poor wound healingPoor wound healing Immunologic abnormalitiesImmunologic abnormalities
BBone Setting CTone Setting CT
X-X-Ray & 3-D CTRay & 3-D CT
Closure of Oro-Antral FistulaClosure 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