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February 6, 2020

Postrhinoplasty Infection With Residual Expanded Polytetrafluoroethylene-Coated Silicone Implantation

Author Affiliations
  • 1Department of Otolaryngology, Head and Neck Surgery, Shin Kong Wu Ho-Su Memorial Hospital; Taipei, Taiwan
  • 2Department of Otorhinolaryngology-Head and Neck Surgery, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
  • 3School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
  • 4Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
  • 5Department of Otolaryngology, Head and Neck Surgery, National Taiwan University Hospital; Taipei, Taiwan
  • 6Institute of Biomedical Engineering, National Taiwan University; Taipei, Taiwan
JAMA Otolaryngol Head Neck Surg. Published online February 6, 2020. doi:10.1001/jamaoto.2019.4616

A woman in her 60s and a woman in her 50s, both without previous systemic diseases, underwent rhinoplasty using an expanded polytetrafluoroethylene (ePTFE)-coated silicone implant 1 year before presentation. The patients experienced postrhinoplasty infection 3 months and 1 year after the operation, respectively. Removal of the implant was performed along with antibiotics use, but their symptoms progressed despite treatment. They were both referred to a tertiary hospital for further treatment. In both cases, computed tomographic scans revealed soft-tissue swelling and fatty infiltration along the linear hyperattenuating enhancement, suspect foreign body, or residual rhinoplasty material (Figure 1 and Figure 2). Incomplete implant removal was suspected, so exploratory implant removal in a minimally invasive fashion by endoscopic assistance was performed. Residual ePTFE sheets were found in the nasal dorsum area during operation. It appeared that only the central part of the implant (silicon material) was retrieved during the first attempt at implant removal; the outer layers of the implant (the ePTFE sheath) remained. After surgery, their symptoms improved with postoperative antibiotics use. After being discharged with oral antibiotics, the patients exhibited no further symptoms.

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