Reconstruction Of Orbital Floor Fractures Research Articles

Reconstruction of Orbital Floor Fractures with Porous Polyethylene Implants: A Prospective Study.

The main aim of our study was to assess and evaluate the efficacy, long standing outcome and infection of porous polyethylene implants in treatment of orbital floor fractures. Twelve patients with fractures of orbital floor were included in the study. The cause of fracture was road traffic accident, self fall and cow hit respectively. They also complained of enophthalmos (n=9), diplopia (n=3), restricted eye movement (n=2), impairment of infraorbital nerve (n=3) and dystopia (n=6). All the fractures were reconstructed with thin porous polyethylene sheets. No implants were extruded and there were no signs of inflammatory reactions against porous polyethylene implant. In all nine patients with pre-op enophthalmos it was corrected post-operatively with p value = 0.000 and was statistically significant; diplopia in one patient was corrected; persistence of double vision was noted in two patients. Restricted eye movement was corrected in all patients, dystopia was corrected in four patients and in two patients have persisting dystopia. Paresthesia persisted in all three patients. Our experience was that reconstruction of orbital floor fracture using porous polyethylene implant is reliable, safe and effective and may be used for reconstruction of the orbital floor fracture with no donor site morbidity.

The use of anatomically drop-shaped bioactive glass S53P4 implants in the reconstruction of orbital floor fractures—A prospective long-term follow-up study

An isolated fracture of the orbital floor needs reconstruction if there is a clear herniation of adipose tissue or of the rectus inferior muscle into the maxillary sinus. A prospective study was carried out treating 20 patients with an isolated blow-out fracture of the orbital floor or with a combined zygomatico-orbito-maxillary complex fracture, using a newly designed anatomically drop-shaped implants made of bioactive glass (BAG) S53P4. Computed tomography (CT) was performed immediately postoperatively to confirm the correct position of the plate. The patients were followed up for an average of 32 months clinically and radiologically with magnetic resonance imaging (MRI) for an average of 31 months. None of the patients had any signs of complications related to the implant and the clinical outcome was very good. None of the patients had persisting diplopia. The level of the pupillas was normal in 15 of 20 patients. Minor hypo-ophthalmos ranging from 0.5 to 1.0 mm was observed in three patients, and moderate hypo-ophthalmos of 2.0 mm was seen in one patient. Hyperophthalmos of 1.0 mm was seen in one patient. Minor enophthalmos on the operated side ranging from 0.5 to 1.0 mm was seen in eight patients. Mild to moderate paraesthesia of the infraorbital nerve was observed in six patients. The immediate postoperative CT and the long term follow-up MRI revealed that the drop-shaped BAG implants retained their correct position in the orbital floor and did not show any evidence of losing their original shape or material resorption. No adverse tissue reaction was associated with the material. Due to the anatomical drop shape, the implants could successfully maintain the orbital volume and compensate for the retrobulbar adipose tissue atrophy.

Reconstruction of Orbital Floor Fractures with Autogenous Bone Graft Application from Anterior Wall of Maxillary Sinus: A Retrospective Study.

Orbital wall fracture implies a situation where disruptions of the walls or floor have occurred. It is a blowout type fracture where bone fragments with torn periosteum are pushed outside of the original bony orbit. There is no intact bone even near the defect area except the thin bone rim surrounding the blowout fracture. The purpose of this defect repair is to support orbital contents, free entrapped tissue, and, especially, restore the original orbital volume. Ten patients (seven males and three females) who underwent repair of orbital floor factures with maxillary sinus bone grafts were included in this study. Surgical procedure for harvesting graft and its fixation was almost same in all operated cases. The collection in the maxillary sinus due to fracture of floor of orbit, blood and bony fragments collected in the maxillary sinus can be easily drained and removed after removal of anterior wall of maxillary sinus and through the same approach you can reduce the floor of orbit manually to the proper position which helps to decease the orbital floor defect.

ORBITAL FLOOR RECONSTRUCTION WITH TITANIUM MESH;

Objective: To determine the outcome of orbital floor reconstruction with titaniummesh in terms of diplopia, enophthalmos, dystopia and infection etc. Study design: Descriptivecase series. Place & duration of study: Department of Oral & Maxillofacial Surgery, PunjabMedical College / Allied Hospital Faisalabad. One and Half year from 01-10-12 to 31-03-14.Material and Method: Twenty two patients clinically and radiographically having defect in theorbital floor due to trauma were included in the study. Titanium mesh was used to reconstruct theorbital floor through infraorbital rim incision and secured in place with 5mm micro screws. Thevariables to be analyzed were diplopia, enophthalmos, orbital dystopia and infection. Results: Inour study male gender predominates over female 20/22. Mean age of patients is 29.36 years ±5.21. Diplopia persisted in 2/10 (20%) patients. Enophthalmos persisted in 7/18 (38.8%) patients.dystopia persisted in ¼ (25%) patients. Infection didn’t develop in any of our patient (0%). Visualacuity was not affected in any of the patient (0%). Conclusions: Titanium mesh is a suitablematerial for reconstruction of orbital floor fractures with little complication rate and no donor sitemorbidity.

USO DE MALLA DE MARLEX® EN EL TRATAMIENTO DE FRACTURAS DE SUELO DE ÓRBITA

Use of Marlex ® mesh for the treatment of orbital floor fracture Background: The selection of the biomaterial to be used for reconstruction of orbital floor fractures de pends on several factors such as the size of the defect, walls involved, internal contours, restoration of appropriate volume, elapsed time of the trauma and surgeon’s experience. A treatment option is the use of Marlex ® mesh. Case report: We report an 18 years old male victim of physical aggression, referred to the emergency service, with an orbital floor trauma. Marlex ® mesh was used for reconstruction of the defect. Postoperative clinical assessment and CT scans performed at 30 and 180 days, showed full functional recovery.

Orbital Fractures and Ocular Injury: Is a Postoperative Ophthalmology Examination Necessary?

To determine whether formal ophthalmology evaluation is necessary after operative repair of orbital fractures and the association of an ocular injury to the severity of facial injury. This was a retrospective cohort study of patients with orbital fractures undergoing operative repair from 2005 to 2013. Subjects were included if they had undergone reconstruction of orbital floor fractures and had data from pre- and postoperative examinations by the oral and maxillofacial surgery and ophthalmology services available. The predictor variables included the service performing the ocular examination (oral and maxillofacial surgery or ophthalmology) and the number of fractures present. The outcome variables were the presence of pre- and postoperative ocular injuries. Logistic regression models were used to determine the relationship of the fracture number to ocular injury. A total of 28 subjects had undergone repair of orbital fractures with preoperative and postoperative examinations performed by both services. Preoperative ocular injuries were found in 17 of the 28 subjects. Those detected by oral and maxillofacial surgeons were limited to changes in visual acuity, pupillary response, and extraocular muscle dysfunction in 11 subjects. Two subjects had new postoperative ocular findings that were considered minor and did not alter management. An increasing number of facial fractures was associated with an increased risk of ocular trauma. Those with 3 or more fractures had an odds ratio of 14.625 (95% confidence interval, 2.191 to 97.612, P = .006) for the presence of ocular injury. Operative repair of orbital fractures did not lead to new ocular injuries that would change the management. Thus, those without preoperative ocular injuries will not require a formal postoperative ophthalmology examination. However, the subjects with more fractures had an increased likelihood of ocular injuries.

Single-Donor Allogeneic Platelet Fibrin Glue and Osteoconductive Scaffold in Orbital Floor Fracture Reconstruction

Commonly used materials for orbital floor fracture reconstruction include autologous cranial bone graft and titanium mesh. We have evaluated here a biomaterial combining biphasic calcium phosphate (hydroxyapatite [HA]/β-tricalcium phosphate [TCP]) osteoconductive scaffold with single-donor allogeneic platelet fibrin glue. The study was conducted on 10 consecutive patients with a follow-up of up to 4 years. Platelet fibrin glue was prepared by mixing equal volumes of single-donor platelet-rich plasma and cryoprecipitate with HA/β-TCP followed by activation with human thrombin prepared by plasma activation. Postoperative evaluations included serial photographs, repeated physical examination, and 3-dimensional computed tomography scan performed 2 years after surgery. The fibrin-rich platelet biomaterial was easy to mold and to apply on the surgical site allowing the surgeon to sculpt accurately the bone defect, providing mechanical stability while avoiding spillage of the scaffold. No infection of the orbit or extrusion of HA/β-TCP was observed. Ocular motility was normal, and no diplopia or enophthalmos of the injured orbit was noted. Coronal computed tomography scans of the reconstructed orbits revealed good restoration of the orbital floor defect in all 10 patients. The use of single-donor platelet fibrin glue combined with an osteoconductive scaffold offers a valuable alternative to autologous cranial bone graft or titanium mesh in the reconstruction of orbital floor bone defect.

Open reduction versus endoscopically controlled reconstruction of orbital floor fractures: a retrospective analysis

Open reduction versus endoscopically controlled reconstruction of orbital floor fractures: a retrospective analysis

Use of anteriolateral wall of maxilla for reconstruction of orbital floor fracture: A clinical study

Purpose:The aim of the present study was to assess the utility of anterolateral wall of maxilla as a bone graft to reconstruct the continuity of orbital floor.Materials and MethodsThis study was carried out at Datarkar Institute of Maxillofacial Surgery, Pratap Nagar, Nagpur. Out of five patients selected, three were male and two were female. All the patients had intact anterolateral wall of maxilla on contralateral side. In all the patients the reduction of the zygomatic complex fracture was done by Keen's approach. The fractures were stabilized by miniplates. From the contralateral sides,bone graft of 1.5 × 2 cm size was harvested from which were intact in all the patients. All the patients were reviewed at regular interval, initially once every week for 1 month, followed by once in every month for next 6 months postoperatively.Results:Five patients with orbital floor defects of medium size average 1.16 cm size (range 0.8-1.5 cm) were grafted by using autogenous bone graft harvested from anterolateral wall of maxilla. All the patients were successfully reconstructed with restoration of the orbital wall continuity. We have not come across any complications like infection, exposure, and extrusion of the graft. Only one patient did not show much improvement in enopthalmous where the size of the defect was large.Conclusions:The use of harvested bone graft from the anterolateral wall of the maxilla is better option for the reconstruction of orbital floor defects.

Materials Used for Reconstruction After Orbital Floor Fracture

Advances in biotechnology continue to introduce new materials for reconstruction of orbital floor fractures. Which material is best fit for orbital floor reconstruction has been a controversial topic. Individual surgeon preferences have been supported by inconsistent inconclusive data. The purpose of this study was to assess and analyze published evidence supporting various materials used for orbital floor reconstruction and to develop a decision-making algorithm for clinical application. A systematic literature review was performed from which 48 studies were selected after primary and secondary screening based on set inclusion and exclusion criteria. This cumulatively included 3475 separate orbital floor reconstructions. Results revealed risk and benefit profiles for all materials. Autologous calvarial bone grafts, porous polyethylene, and polydioxanone (PDS) were most widely used for orbital floor reconstruction. Increased infection rates were reported with polyglactin 910/PDS composites and silastic rubber. Ocular motility was reduced most with lyophilized dura and PDS. Preoperative and postoperative rates for diplopia and enophthalmos varied among the materials. In conclusion, our results revealed continued inadequate evidence to exclusively support the use of any one biomaterial/implant for orbital floor reconstruction. Results have served to create a decision-making algorithm for clinical application. Our authors propose certain parameters for future studies seeking to demonstrate a comparison between 2 or more materials for orbital floor reconstruction.

Comparison of Early Fibrovascular Proliferation According to Orbital Implant in Orbital Floor Fracture Reconstruction

Although reports of successful treatment results of orbital fractures are numerous, histopathologic changes associated with favorable outcomes have not yet been established. The purpose of this study was to observe fibrovascular ingrowth into implants, fibrovascularization, and inflammatory reactions in surface tissues of implants in an animal model of orbital floor fractures. Twenty-four New Zealand white rabbits were used in the study. A standardized 6-mm-diameter defect was made bilaterally in the maxillary sinuses to include bone and mucosa, and an 8 × 8-mm alloplastic implant was inserted. In the control group, a bone defect was made, but no implant was inserted. Two different implant materials 1 mm in width were used: porous high-density polyethylene (Medpor, group A) and absorbable copolymer (Macropore, group B). The implants were harvested at 1, 2, and 6 weeks after implantation. Hematoxylin-eosin stains and immunohistochemical studies of basic fibroblast growth factor (bFGF) and CD31 (platelet/endothelial cell adhesion molecule) were conducted. Full-thickness fibrovascular ingrowth into the implants was observed in group A after 2 weeks, but there was no fibrovascular ingrowth into the implant in group B. The inflammatory reactions between the implant and the connective tissue were grade 2 at 1 week and grade 1 at 2 and 6 weeks in both groups. The bFGF indexes in fibrovascular tissue growing into the nonabsorbable porous polyethylene implants (group A-1) were 0.3 at 1 week, 2.3 at 2 weeks, and 3.0 at 6 weeks. The bFGF indexes at the surface tissues of the implant in the nonabsorbable porous polyethylene implants (Medpor, group A-2) and group B were 1.0 and 1.8 at 1 week, 2.5 and 2.8 at 2 weeks, and 3.0 and 3.0 at 6 weeks. Expressions of CD31 in group A-1 were 3.8 at 1 week, 6.0 at 2 weeks, and 20.3 at 6 weeks. Expressions of CD31 in group A-2 and group B were 19.8 and 23.3 at 1 week, 38.0 and 49.3 at 2 weeks, and 64.3 and 72.0 at 6 weeks. Because there was no fibrovascular ingrowth into the absorbable copolymer implant, such implants may be advantageous in orbital wall fractures with exposures of extraocular muscle. However, the possibility of migration and extrusion of the implant cannot be excluded because there was no fibrovascular ingrowth into the absorbable copolymer implants. Therefore, nonabsorbable porous polyethylene implants are better suited for use in orbital wall fractures when there is concern about implant migration and extrusion during the early postoperative period and large orbital wall fractures.

Open reduction versus endoscopically controlled reconstruction of orbital floor fractures: a retrospective analysis

The aim of this study was to compare the postoperative results of open reduction versus endoscopically controlled reconstructions of orbital floor fractures. The medical records of 83 patients, treated between January 2000 and December 2008, were reviewed for enophthalmos, diplopia and complications. Fifty-eight patients were operated on using open reduction and in 25 patients the open reduction was endoscopically controlled. A significantly better outcome, regarding enophthalmos and diplopia improvement, was found in the endoscopically controlled group. Endoscopically controlled reconstruction of orbital floor fractures seems to be a more accurate and successful treatment.

Traumatic Orbital Floor Fractures: Repair With Autogenous Bone Grafts in a Tertiary Trauma Center

To evaluate the outcome of autologous bone grafts in the reconstruction of orbital floor fractures. A retrospective interventional case series was performed at a tertiary trauma center. All patients with traumatic orbital floor fractures that had been reconstructed using calvarial or iliac autogenous bone grafts from August 2006 to January 2010 were included in the present study. The operations were performed by the same team of maxillofacial and oculoplastic surgeons. The patients were evaluated pre- and postoperatively for the presence of enophthalmus and diplopia. The surgical technique was tailored to best fit the patient's clinical characteristics, with attention to the cosmetic and functional outcomes and the preferred use of a sutureless transconjunctival technique, when applicable. The main outcome measures were residual enophthalmus, diplopia, and the complication rate. A total of 16 patients (11 males and 5 females), with an average age of 34.4 years, underwent orbital floor reconstruction using an autologous bone graft. Calvarial and iliac bone grafts were used in 11 and 5 patients, respectively. A transconjunctival approach was applied in 10 patients. All patients achieved good cosmetic and functional outcomes, with improvement in enophthalmus. Three patients had residual diplopia postoperatively that was probably due to traumatic muscular injury. No significant perioperative or long-term complications were noted during a mean follow-up of 12.5 months. Reconstruction of orbital floor fractures after trauma using autologous bone grafts is safe and associated with a low rate of complications. Combining the appropriate surgical approach with multidisciplinary teamwork results in excellent cosmetic and functional outcomes and allows for efficient and comprehensive postoperative management.

Mydriasis during Orbital Floor Fracture Reconstruction: A Novel Diagnostic and Treatment Algorithm

Orbital floor fractures are the most commonly encountered traumatic fractures in the facial skeleton. Mydriasis that is detected during orbital floor fracture reconstruction may cause significant distress to surgeons, as it may be associated with sinister events such as visual loss. It is not an uncommon problem; previous studies have shown the incidence of mydriasis to be 2.1%. The combination of careful preoperative evaluation and planning, as well as specific intraoperative investigations when mydriasis is encountered, can be immensely valuable in allaying surgeons' anxiety during orbital floor fracture reconstruction. In this review article, the authors discuss the common causes of mydriasis and present a novel systematic approach to its diagnostic evaluation devised by our unit that has been successfully implemented since 2008.

Comparison of the Supporting Strength of a Poly-l-Lactic Acid Sheet and Porous Polyethylene (Medpor) for the Reconstruction of Orbital Floor Fractures

The aim of this study was to elucidate the supporting strength of the curved poly-L-lactic acid (PLLA) sheet and porous polyethylene (Medpor) for reconstruction of orbital floor fractures. For one-half and two-thirds orbital floor fractures, reconstruction was performed using the PLLA sheet and Medpor. The PLLA sheet was molded to fit the orbital floor (concavity). The anterior portion (1 cm) was curved to fit the inferior orbital rim and fixed with a screw. Medpor was designed to fit the orbital floor. A screw was fixed 6 mm away from the anterior border of the orbital floor. Each implant was hung by wire, and the degree of sagging of the implant was measured using micrometers by the power of a force gauge. For one-half orbital floor fractures, the power of the PLLA sheet to sag 5 mm was 2.46 (SD, 0.14) N, and that of Medpor was 0.59 (SD, 0.04) N. The power of the PLLA sheet to sag 10 mm was 6.9 (SD, 0.14) N, and that of Medpor was 1.52 (SD, 0.16) N. For two-thirds orbital floor fractures, the power of the PLLA sheet to sag 5 mm was 1.79 (SD, 0.24) N, and that of Medpor was 0.39 (SD, 0.04) N. For 10 mm of sagging, the power of the PLLA sheet was 5.61 (SD, 0.29) N, and that of Medpor was 0.94 (SD, 0.09) N. For sagging of 15 mm, the power of the PLLA sheet was 8.99 (SD, 0.16) N, and that of Medpor was 2.98 (SD, 0.24) N. The PLLA sheet was irreversibly bent when the force reached approximately 8 to 9 N. For Medpor, the degree of sagging during the early stage was larger than at the later stage. In all situations, the supporting power of the PLLA sheet was greater than that of Medpor. The differences were significant in all situations (P = 0.000). The degree of sagging in one-half orbital floor fractures was 2.87 mm for the PLLA sheet and 7.96 mm for Medpor. There was an increased orbital volume of 0.4 mL with the PLLA sheet and 1.19 mL for Medpor. The predicted enophthalmos was 0.41 mm with the PLLA sheet and 1.07 mm with Medpor. The degree of sagging for the two-thirds orbital floor fractures was 4.28 mm for the PLLA sheet and 11.47 mm for Medpor. The increased orbital volume was 0.78 mL for the PLLA sheet and 2.22 mL for Medpor. The predicted enophthalmos was 0.73 mm with the PLLA sheet and 1.93 mm with Medpor. The predicted enophthalmos was below 2 mm with both the PLLA sheet and Medpor for reconstruction of orbital floor fractures; however, it was near 2 mm with Medpor in reconstruction of two-thirds orbital floor fractures. The results of this study show that the PLLA sheet and Medpor were sufficient for reconstruction of one-half and two-thirds orbital floor fractures with a defective posterior part. However, the supporting power of the PLLA sheet was stronger than that of Medpor.

Comparative Study of Evaluation of Results of Orbital Floor Reconstruction with Calvarial Bone Graft Vs Sialastic Implant

Introduction: Orbital floor fractures can result in considerable facial deformity. A vast array of autogenous and alloplastic materials are being used to reconstruct Orbital floor defects. Amongst the alloplastic materials sialastic implants are most commonly being used for orbital floor reconstruction whilst among the autogenous bone grafts calvarial bone graft are commonly used. Unfortunately no study has been conducted in Pakistan to compare the post operative results of these two commonly used materials for orbital floor reconstruction. The aim of this study is to compare the results of orbital floor reconstruction using sialastic implants and calvarial bone graft in order to find out which of the two materials shows better post operative results. Methods: A Quasi experimental randomized trial was conducted from November 2006 to November 2007 in the department of Oral and Maxillofacial surgery, King Edward Medical University/Mayo Hospital, Lahore. A total of 60 patients were recruited over a period of 12 months. All patients were followed up at regular intervals i.e. 1 week, 2 weeks, 2 months and 6 months. The six month evaluation of Orbital floor reconstruction was done by noting the improvement in diplopia, enoph-thalmous and presence or absence of infection, extrusion, dislodgement in 30 cases with calvarial bone graft (group A) and in 30 cases with sialastic implants (group B). Results: Approximately 44% patients presented with one of the post operative complaints of diplopia, enophthalmous and both (diplopia and enophthalmous) at the 6 months follow up in group B as compared to only 17% patients with post operative complaints in group A (p = 0.05). Post operative complications i.e. infection, extrusion and dislodgement occurred in 43.4% patients from group B as compared to 20% patients from group A (p = 0.02). Conclusion: Reconstruction of orbital floor fracture with autogenous bone (calvarial bone) should be preferred as compared to reconstruction with the sialastic implants because of lesser post operative complications. Key Words: Orbital floor defect, Orbital rim, Para Nasal Sinus, Computerized tomogram, Magnetic Resonance Imaging, intraocular pressure.

P.098 Reconstruction of orbital floor fracture: Clinical and MR imaging long-term results

Trauma is a major public health problem and organized systems of trauma care have been shown to substantially reduce trauma-related mortality. Currently California and many other states have incompletely developed systems of trauma care delivery. This study was undertaken to determine how frequently patients incurring serious trauma in California receive treatment at a trauma center.Hospital discharge records for 360,743 acute trauma patients for 1995 to 1997 were analyzed. Abbreviated Injury Scale scores were calculated from discharge diagnosis codes. Severity of trauma and the need for trauma center treatment was defined by eight Abbreviated Injury Scale criteria combined with patient age and type of injury.According to study criteria, 67,718 patients needed trauma center care and 56% were treated at a trauma center. Among patients less than 55 years of age, 62% were treated at a trauma center compared with 40% of those aged 55 years or more (p < 0.0001). For patients less than 55 years old with brain injuries, 66% were treated at a trauma center compared with 44% for patients aged 55 years or more (p < 0.0001). Of the 29,849 patients who met Abbreviated Injury Scale criteria but were not treated at trauma centers, 59% were in counties with designated trauma centers and 41% were in counties without trauma centers.Only 56% of seriously injured patients in California were treated at trauma centers, despite most of the injuries occurring in the catchment areas of designated trauma care systems. Substantial undertriage of serious trauma patients to trauma centers appears to be occurring, especially in older persons and in persons with brain injuries. Efforts to understand why undertriage is occurring so frequently are hampered by fragmentation of the systems of care, inadequate data management systems, and lack of trauma care performance reporting by non–trauma center hospitals.

O.039 Reconstruction of orbital floor fractures. A current surgical management

O.039 Reconstruction of orbital floor fractures. A current surgical management

Porous Polyethylene Implants in Orbital Floor Reconstruction

Background/Purpose: Various alloplastic materials are used in orbital wall reconstruction. This study investigated the outcome of patients treated with porous polyethylene sheet implants in the reconstruction of orbital floor fracture. Methods: Twenty-one patients who underwent orbital reconstructions using 0.85-mm porous polyethylene sheets for the repair of orbital floor fracture were included. A transconjunctival approach was used in all patients. The mean duration of postoperative follow-up was 29.7 ± 12.3 months. Postoperatively, results and complications such as infection and implant extrusion were followed-up on the first day, the first week, monthly for the first 3 months and then every 3–6 months thereafter. Results: All 21 patients had symptomatic diplopia before surgery. The diplopia resolved in 14 patients and improved in seven patients within the first month after surgery. All patients except one were free from diplopia at follow-up periods exceeding 6 months. Preoperative enophthalmos resolved in four of seven patients and improved in three. None of the patients developed orbital infection, implant exposure or migration, worsening diplopia, infraorbital anesthesia or loss of vision during follow-up. Conclusion: The study demonstrated that porous polyethylene implants in the repair of orbital wall fractures had good results with few complications. [J Formos Med Assoc 2007;106(1):51–57]

Reconstruction of Orbital Floor Fracture With Polyglactin 910/Polydioxanon Patch (Ethisorb): A Retrospective Study

We sought to evaluate the effectiveness and the complications related to the use of Ethisorb (resorbable alloplastic material) in the reconstruction of orbital floor fractures. We retrospectively reviewed the charts of all patients who underwent orbital floor fracture reconstruction with Ethisorb since 2001. We only included patients with a minimum follow-up of 3 months. The following data were recorded for every patient: age, gender, cause of trauma, time from trauma to surgery, signs and symptoms, concomitant ocular injuries, radiographic analysis, pertinent intraoperative findings (including the type of approach), follow-up time, and postoperative complications. Eighty-seven patients were included in the study. Twenty-one patients (24.1%) experienced postoperative complications. Of these, only 3 patients (3.4%) had permanent complications directly related to the Ethisorb membrane (diplopia, enophthalmos). Two of these patients required revision surgery and are discussed in the article. The results of our study demonstrate the effectiveness of Ethisorb in the repair of small-to-moderate orbital floor fracture defects (up to a maximum size of 2 x 2 cm).