- Email: [email protected]
Polyvinylsiloxane dental impression material used to support the pinna after severe injury
British Journal of Oral and Maxillofacial Surgery (2004) 42, 257—258
SHORT COMMUNICATION
Polyvinylsiloxane dental impression material used to support the pinna after severe injury G.W. Bell*, M.H. Clark Department of Oral and Maxillofacial Surgery, Dumfries and Galloway Royal Infirmary, Bankend Road, Dumfries DG1 4AP, UK Accepted 14 February 2004
KEYWORDS Pinna; Polyvinylsiloxane; Dental impression
Summary This case illustrates the simple, cheap and immediate provision of a splint for the pinna after severe injury using dental polyvinylsiloxane impression material. © 2004 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Even after mutilating injuries to the pinna, much if not all of the tissue can be reconstructed. This is facilitated by the good blood supply, and the numerous landmarks that allow accurate insertion of skin and cartilaginous sutures. However, most important of all is the preservation of all viable tissue.1,2 The use of a support for the pinna during the healing process is not essential, and the decision to do so will vary from one surgeon to another and with injuries of differing severity. The use of polyvinylsiloxane dental material to support cartilaginous structures is not new,3 but has not to our knowledge been reported for use after reconstruction of the injured pinna. We used it in the case of a 26-year-old woman who had been attacked by a dog (Figs. 1—3). She was given an injection of tetanus toxoid and antibiotic; and the pinna was debrided and reconstructed under general anaesthesia. Non-absorbable monofilament sutures were used for cartilage and skin. The external auditory meatus was then sealed with paraffin gauze and the contours of the pinna were filled *Corresponding author. Tel.: +44-1387-246246; fax: +44-1387-241514. E-mail address: [email protected] (G.W. Bell).
Figure 1
The mutilated right pinna.
0266-4356/$ — see front matter © 2004 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjoms.2004.02.009
258
Figure 2 The reconstructed right pinna with paraffin gauze in the external auditory meatus and polyvinylsiloxane dental impression material in place.
with the impression material using an automatic dispenser. A pressure dressing was also applied. The mould, apart from preventing the development of a haematoma, acted as a support to prevent collapse of the cartilaginous skeleton and contraction of the pinna. The mould was removed after 1 week to allow removal of sutures and reapplied. The patient wore it at night and in the evenings for a month. Polyvinylsiloxane dental material is stable, nontoxic, non-carcinogenic, has no hazardous products of decomposition, and does not support the growth of microorganisms (ISO 1093339, Biological evaluation of medical devices). We think that this technique is easy to use and reliable, and the material
G.W. Bell, M.H. Clark
Figure 3 The right pinna 4 weeks after operation showing a small area of necrosis at the upper border of the helix. The area of necrosis healed completely causing only slight scarring and contraction, but minimal change to the height and width of the pinna.
is readily available is most oral and maxillofacial surgery units.
References 1. Manson PN. The face. In: McCarthy JG, editor. Plastic surgery, vol. 2. New York: WB Saunders; 1990. p. 912—4. 2. Clemons J, Severeid LR. Trauma. In: Cummings CW, editor. Otolaryngology–—head and neck surgery, vol. 4. Toronto: CV Mosby; 1986. p. 2911—8. 3. Gregory G, Das Gupta R, Morgan B, Bounds G. Polyvinylsiloxane dental bite registration material used to splint a composite graft of the nasal rim. Br J Oral Maxillofac Surg 1999;37:139—41.
SHORT COMMUNICATION
Polyvinylsiloxane dental impression material used to support the pinna after severe injury G.W. Bell*, M.H. Clark Department of Oral and Maxillofacial Surgery, Dumfries and Galloway Royal Infirmary, Bankend Road, Dumfries DG1 4AP, UK Accepted 14 February 2004
KEYWORDS Pinna; Polyvinylsiloxane; Dental impression
Summary This case illustrates the simple, cheap and immediate provision of a splint for the pinna after severe injury using dental polyvinylsiloxane impression material. © 2004 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Even after mutilating injuries to the pinna, much if not all of the tissue can be reconstructed. This is facilitated by the good blood supply, and the numerous landmarks that allow accurate insertion of skin and cartilaginous sutures. However, most important of all is the preservation of all viable tissue.1,2 The use of a support for the pinna during the healing process is not essential, and the decision to do so will vary from one surgeon to another and with injuries of differing severity. The use of polyvinylsiloxane dental material to support cartilaginous structures is not new,3 but has not to our knowledge been reported for use after reconstruction of the injured pinna. We used it in the case of a 26-year-old woman who had been attacked by a dog (Figs. 1—3). She was given an injection of tetanus toxoid and antibiotic; and the pinna was debrided and reconstructed under general anaesthesia. Non-absorbable monofilament sutures were used for cartilage and skin. The external auditory meatus was then sealed with paraffin gauze and the contours of the pinna were filled *Corresponding author. Tel.: +44-1387-246246; fax: +44-1387-241514. E-mail address: [email protected] (G.W. Bell).
Figure 1
The mutilated right pinna.
0266-4356/$ — see front matter © 2004 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjoms.2004.02.009
258
Figure 2 The reconstructed right pinna with paraffin gauze in the external auditory meatus and polyvinylsiloxane dental impression material in place.
with the impression material using an automatic dispenser. A pressure dressing was also applied. The mould, apart from preventing the development of a haematoma, acted as a support to prevent collapse of the cartilaginous skeleton and contraction of the pinna. The mould was removed after 1 week to allow removal of sutures and reapplied. The patient wore it at night and in the evenings for a month. Polyvinylsiloxane dental material is stable, nontoxic, non-carcinogenic, has no hazardous products of decomposition, and does not support the growth of microorganisms (ISO 1093339, Biological evaluation of medical devices). We think that this technique is easy to use and reliable, and the material
G.W. Bell, M.H. Clark
Figure 3 The right pinna 4 weeks after operation showing a small area of necrosis at the upper border of the helix. The area of necrosis healed completely causing only slight scarring and contraction, but minimal change to the height and width of the pinna.
is readily available is most oral and maxillofacial surgery units.
References 1. Manson PN. The face. In: McCarthy JG, editor. Plastic surgery, vol. 2. New York: WB Saunders; 1990. p. 912—4. 2. Clemons J, Severeid LR. Trauma. In: Cummings CW, editor. Otolaryngology–—head and neck surgery, vol. 4. Toronto: CV Mosby; 1986. p. 2911—8. 3. Gregory G, Das Gupta R, Morgan B, Bounds G. Polyvinylsiloxane dental bite registration material used to splint a composite graft of the nasal rim. Br J Oral Maxillofac Surg 1999;37:139—41.