Reconstruction of Post-traumatic Internal Orbital Wall Defects with Titanium Mesh

Abstract

The management of orbital injuries is one of the most interesting and difficult areas in facial trauma. The improper reconstruction of the orbit frequently results in ophthalmic complications. Though a number of materials are available for use in orbital wall reconstruction, at present titanium mesh could be considered to be the ideal orbital floor repair material. The study involved patients with symptomatic zygomatico-orbital fractures requiring orbital wall reconstruction. Under general anaesthesia the floor of orbit was explored and reconstructed with contoured titanium mesh after repositioning of the entrapped orbital contents. The patients were on periodic follow-up for 6weeks where clinical and radiographic data were recorded. Ten male patients age ranging from 22 to 53years (mean 29.88years) received titanium implants for impure orbital fractures (eight patients) and pure orbital floor fractures (two patients). The main cause of fractures was road traffic accidents. They also complained of enophthalmos (n=7), diplopia (n=4), infraorbital nerve paresthesia (n=6), dystopia (n=1) and epiphora (n=2). No implant extrusion or infection was seen. The symptoms were corrected in six patients with enophthalmos, three with diplopia, four with infraorbital nerve paresthesia and all patients with epiphora. Dystopia persisted post-surgically in one patient. Titanium orbital implants were used to confirm titanium as a useful repair material for orbital floor fractures. Their use leads to less morbidity as no donor site operation is needed. Also it provides favourable healing as it is biocompatible.