An evaluation of the support provided by common internal orbital reconstruction materials

Haug, Richard H.; Nuveen, Erik J.; Bredbenner, Todd L.

doi:10.1016/s0278-2391(99)90076-9

Cited by 55 publications

(37 citation statements)

References 30 publications

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“…2,3 This biological stabilization also prevents migration or extrusion of the implant, making fixation unnecessary with screws or sutures. 2,22 The ultra-thin implant can be cut easily with scissors and molded to cover a wide variety of orbital defects. It also maintains its shape, facilitating implantation.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Ultra-Thin Porous Polyethylene Implants used for Reconstruction of Orbital Floor Defects

Öztürk

Şengezer

Işık

et al. 2005

Journal of Craniofacial Surgery

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Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Ultra-Thin Porous Polyethylene Implants used for Reconstruction of Orbital Floor Defects

Öztürk

Şengezer

Işık

et al. 2005

Journal of Craniofacial Surgery

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“…Only marlex mesh failed to uphold the load applied. 20 Ideally, an orbital implant approximates the thickness of the natural orbital floor, has similar viscoelastic properties, and is suffi- ciently rigid to prevent deformation. 9,19 It is easy to manipulate, is not prone to infection or extrusion, and is easily anchored to surrounding structures.…”

Section: Discussionmentioning

confidence: 99%

Orbital Floor Fractures

Kirby¹,

Turner²,

Davenport³

et al. 2011

Annals of Plastic Surgery

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Since the 1950s, myriad materials have been used to reconstruct orbital floor fractures. Technological advances have afforded new materials for reconstruction. Recent comparisons of materials have not been reported. Retrospective chart review was performed using current procedural terminology coding for orbital floor fractures treated between 1991 and 2009. A total of 510 charts were reviewed; 317 adult patients met criteria. Forty-seven of these patients underwent bilateral floor explorations, yielding 364 orbital floor fractures. Mean age was 33.7 years. Motor vehicle collision, assault, all-terrain vehicles, and falls constituted the majority of injury mechanisms. Impure blowouts were the most common fracture type, and zygomaticomaxillary complex fractures were the most common pattern. Materials included autologous bone, porous polyethylene, titanium, and porous polyethylene with incorporated titanium. Use of bone graft correlated with postoperative orbital dystopia and enophthalmos, as compared with alloplastic implants. Bone rigidity, unpredictable thickness, and resorption may contribute. Once the gold standard of orbital reconstruction, autologous bone may have been eclipsed by modern materials.

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“…7,8,17 The eyeball dummies were incorporated in the orbit and attached with a string through the optic canal to imitate the common tendinous ring of the human eyeball anatomy. The skull was fixed in a telescope halo frame and was positioned in the Frankfurt plane and bipupillar plane to guarantee correct anatomic position of the eyeball dummy.…”

Section: Custom Design Of a Force And Displacement Transducermentioning

confidence: 99%

“…5 A finite element analysis confirms these results and explains the vulnerability of the orbital floor with its plane architecture compared with the arcaded orbital roof where less bending stress occurred. 6 The weight of the orbital tissue is approximately 35 g, 7,8 and the orbital floor has a size of approximately 30 Â 20 mm, 9 which theoretically results in a maximally applied force of 0.00058 MPa. In addition, the periorbita adhesion in the orbit may alter the effective force.…”

mentioning

confidence: 99%

Forces Charging the Orbital Floor After Fractures

Birkenfeld¹,

Steiner²,

Becker³

et al. 2011

Journal of Craniofacial Surgery

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The objective of this study was first to establish a method to measure forces and displacement of the orbital content in defects of the orbital floor in truncated fresh and unfixed heads and second to characterize reconstruction materials with regard to punctuation strength and compression.Orbital floor defects (10 Â 20 mm and 15 Â 20 mm; 3 mm behind the orbital rim) were prepared after Le Fort I osteotomy. The values of force and displacement were recorded in 6 freshly frozen human heads. In addition, the punctuation strength of 2 reconstruction materials (polydioxanone [PDS] foil and collagen membrane) was evaluated using a Zwick Z010 TN1 universal testing machine. The forces of the orbital content (28.41 [SD, 1.6] g) applied to the defects of 10 Â 20 mm and 15 Â 20 mm with an intact periorbita were 0.04 (SD, 0.003) N (0.0002 MPa) and 0.07 (SD, 0.02) N (0.0002 MPa), respectively, and with a split periorbita were 0.06 (SD, 0.03) N (0.0003 MPa) and 0.08 (SD, 0.06) N (0.00026 MPa), respectively. The displacement values without reconstruction materials of the 10 Â 20-mm and 15 Â 20-mm defects were 0.94 (SD, 0.7) mm and 1.2 (SD, 0.5) mm, respectively. The PDS foil could withstand forces of 118.9 (SD, 14.1) N (0.375 MPa), and the collagen membrane could withstand forces of 44.5 (SD, 5.3) N (0.14 MPa). This is the first study to report forces charging the orbital floor. The presented results support the use of PDS foils and collagen membranes as reconstruction materials for orbital floor defects, at least in smaller and medium-sized fractures.Key Words: Orbital floor fracture, reconstruction material, anatomic model (J Craniofac Surg 2011;22: 1641Y1646) O rbital floor fractures are injuries that frequently have to be treated in craniofacial and maxillofacial surgeries. Approximately 50% of these cases are isolated orbital floor fractures, 1 the other half are combined fractures. Orbital floor defects are said to range in size from 27 to 250 mm 2 . 2 Common complications of orbital floor fractures are diplopia, exophthalmos/enophthalmos, persistent sensibility abnormalities of the infraorbital nerve, and reduced bulbus motility. 3 Surgical treatment decreases the frequency of complications after an orbital floor fracture in approximately 80% of cases. 4 Mechanisms of orbital floor fractures are explained by the hydraulic pressure (bulbus impact) and the buckling force theory (infraorbital rim impact). A cadaver study reported higher forces, which result in orbital floor fractures for the buckling force theory (2.99 J) compared with the hydraulic pressure theory (1.22 J). 5 A finite element analysis confirms these results and explains the vulnerability of the orbital floor with its plane architecture compared with the arcaded orbital roof where less bending stress occurred. 6 The weight of the orbital tissue is approximately 35 g, 7,8 and the orbital floor has a size of approximately 30 Â 20 mm, 9 which theoretically results in a maximally applied force of 0.00058 MPa. In addition, the periorbita adhesion in the orb...

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An evaluation of the support provided by common internal orbital reconstruction materials

Cited by 55 publications

References 30 publications

Long-Term Outcomes of Ultra-Thin Porous Polyethylene Implants used for Reconstruction of Orbital Floor Defects

Long-Term Outcomes of Ultra-Thin Porous Polyethylene Implants used for Reconstruction of Orbital Floor Defects

Orbital Floor Fractures

Forces Charging the Orbital Floor After Fractures

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