Abstract
It is essential to reduce and reconstruct bony defects adequately in large orbital floor fracture and defect. Among many reconstructive methods, alloplastic materials have attracted attention because of their safety and ease of use. We have used resorbable plates combined with artificial bone substitutes in large orbital floor defect reconstructions and have evaluated their long-term reliability compared with porous polyethylene plate. A total of 147 patients with traumatic orbital floor fracture were included in the study. Surgical results were evaluated by clinical evaluations, exophthalmometry, and computed tomography at least 12 months postoperatively. Both orbital floor height discrepancy and orbital volume change were calculated and compared with preoperative CT findings. The average volume discrepancy and vertical height discrepancies were not different between two groups. Also, exophthalmometric measurements were not significantly different between the two groups. No significant postoperative complication including permanent diplopia, proptosis, and enophthalmos was noted. Use of a resorbable plate with an artificial bone substitute to repair orbital floor defects larger than 2.5 cm2 in size yielded long-lasting, effective reconstruction without significant complications. We therefore propose our approach as an effective alternative method for large orbital floor reconstructions.
Highlights
The orbit is a four-sided pyramidal structure that comprises the roof, floor, and medial and lateral bony walls
Many orbital floor reconstruction methods using various materials such as biological substances, resorbable plates, permanent plates, or other alloplastic materials have been developed to date [7,8,9,10,11]
The average area size of the orbital floor defect obtained from preoperative computed tomography (CT) images was not significantly different between the control and combined groups at 3.24 ± 0.61 cm2 and 3.11 ± 0.53 cm2, respectively
Summary
The orbit is a four-sided pyramidal structure that comprises the roof, floor, and medial and lateral bony walls. A “blowout fracture” is defined as a fracture that involves the orbital walls, especially the medial wall and/or orbital floor. Especially those that involve the orbital floor, are associated with complications such as diplopia from extraocular muscle entrapment, ecchymosis, eyelid edema, subconjunctival hemorrhage, and V2 sensory nerve deficit. Many orbital floor reconstruction methods using various materials such as biological substances (autologous bone and cartilage grafts, bone and dural allografts, porcine collagen, and dermal xenografts), resorbable plates (poly l-lactic acid, polyglycolic acid, polydioxanone, composite polymers, and polycaprolactone), permanent plates (porous polyethylene, titanium mesh implant, and titanium mesh coated with porous polyethylene), or other alloplastic materials (silicone sheet and Teflon implant) have been developed to date [7,8,9,10,11]
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