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Allergische Reaktionen auf Bioimplantate

Allergic reactions to bioimplants

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Zusammenfassung

Hintergrund

Bioimplantate werden im HNO-Bereich vielfältig eingesetzt, am häufigsten in der rekonstruktiven Gesichtschirurgie, bei Cochleaimplantaten (CI), knochenverankerten Hörgeräten, PORP/TORP-Prothesen („partial ossicular replacement prosthesis“, „total ossicular replacement prosthesis“), aber auch u. a. bei Paukendrainagen, Larynxkanülen, Stimmprothesen nach Laryngektomie und auch bei „HNO-nahen“ Eingriffen als dentale Implantate in der Zahnmedizin.

Methoden

In einer Literatursuche wurde die Immunologie allergischer Reaktionen auf Bioimplantate analysiert und die vorhandene Evidenz ermittelt durch Recherchen in den Datenbanken Medline, PubMed sowie den nationalen und internationalen Studien- und Leitlinienregistern und der Cochrane Library. Es wurden Humanstudien berücksichtigt, die im Zeitraum bis einschließlich 12/2021 publiziert wurden.

Ergebnis

Basierend auf der internationalen Literatur und bisheriger Erfahrungen wird eine Übersicht über Allergien auf Bioimplantate in der HNO-Heilkunde gegeben.

Schlussfolgerungen

HNO-Ärzte sollten bei Einbringen allogener Materialien immer auch an die Möglichkeit allergischer Reaktionen denken – insbesondere auch, aber nicht nur – bei Bioimplantaten.

Abstract

Background

Bioimplants are used in a variety of ways in otorhinolaryngology, most commonly in facial reconstructive surgery, cochlear implants (CI), bone-anchored hearing aids, and partial/total ossicular replacement prostheses (PORP/TORP), but also for tympanic drainage, laryngeal cannula, voice prostheses after laryngectomy, etc., and in otorhinolaryngology-related procedures as dental implants in dentistry.

Methods

A literature search was performed to analyze the immunology of allergic reactions to bioimplants and to determine the available evidence by searching Medline, PubMed, and national and international study and guideline registries and the Cochrane Library. Human studies published in the period up to and including 12/2021 were considered.

Results

Based on the international literature and previous experience, a review of allergies to bioimplants in otolaryngology is presented.

Conclusion

Otorhinolaryngologists should always consider the possibility of allergic reactions when inserting allogeneic materials, particularly, but not only, when using bioimplants.

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Abbreviations

LPT:

Lymphozyten-Proliferationstest

MMA:

Methylmethacrylat

PMMA:

Polymethylmethacrylat

SI:

Stimulationsindex

TLR4:

Toll-like-Rezeptor

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  1. Zentrum für Rhinologie und Allergologie, An den Quellen 10, 65183, Wiesbaden, Deutschland

    L. Klimek

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Klimek, L. Allergische Reaktionen auf Bioimplantate. HNO 70, 361–370 (2022). https://doi.org/10.1007/s00106-022-01173-x

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