Clin Exp Otorhinolaryngol.  2021 Aug;14(3):321-327. 10.21053/ceo.2020.01725.

Radiologic Findings of Complicated Alloplastic Implants in the Nasal Dorsum

• Kim SH
• Kim JW
• Jang YJ

• KMID: 2519187
• DOI: http://doi.org/10.21053/ceo.2020.01725

Abstract

Objectives
. When performing cosmetic rhinoplasty with alloplastic materials, complications such as implant visualization, inflammation, dislocation, and extrusion should be thoroughly evaluated. Although computed tomography (CT) can provide useful information about the implant status and its interaction with the skin soft tissue envelope (SSTE), the radiologic findings of these interactions have rarely been reported.
Methods
. We retrospectively reviewed the data of 80 patients who underwent facial bone CT or ostiomeatal unit CT at Asan Medical Center between July 2008 and January 2020 for the evaluation of dorsal implants with complications. We reviewed the implantation period, implant dislocation, implant curling or deformation, radiodensity (in Hounsfield units), and nasal bone changes including bone erosion or hyperostosis.
Results
. Of the 80 patients, 67 (83.8%) had silicone implants and 13 (16.2%) had Gore-Tex implants. The radiologic findings of the silicone implants were as follows: maintenance of the implant shape (80.6%), radiolucency (similar density to that of fat tissue) halo (83.6%), and homogeneous attenuation (82.1%). Peri-implant calcification was often found in silicone implants with >20-year implantation periods. The findings of Gore-Tex were as follows: curling or deformation (84.6%), heterogeneous attenuation (84.6%), and consistent peri-implant calcification over time.
Conclusions
. Silicone and Gore-Tex implants have distinctive radiologic features. These findings of alloplastic materials help us to understand how implants behave in the nasal dorsum and how they affect the SSTE.

Keyword

Silicone; Polytetrafluoroethylene; Radiology; Rhinoplasty; Computed Tomography

Figure

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  Fig. 1. Shapes of the dorsal alloplastic implants. Gore-Tex implants showed implant curling and deformation in the sagittal plane on computed tomography (A), while silicone implants usually maintained their shape inside the skin soft tissue envelope (B).

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  Fig. 2. The peri-implant radiolucent halo found with silicone implants (red arrows).

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  Fig. 3. The intra-implant low attenuation found in Gore-Tex implants.

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  Fig. 4. Erosion of the nasal bone was observed due to (A) a silicone implant (the period of insertion was 25 years), (B) a Gore-Tex implant (the period of insertion was 14 years). (C) Hyperostosis of the nasal bone was observed due to a Gore-Tex implant; the periods of insertion were 4 years (left), and 14 years (right).

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  Fig. 5. Peri-implant calcifications of dorsal alloplastic implants. (A) Silicone implants, with periods of insertion of 25 years (left), 40 years (middle), and 18 years (right), (B) Gore-Tex implants (the period of insertion was 15 years).

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