Materials to facilitate orbital reconstruction and soft tissue filling in posttraumatic orbital deformaties

Abstract

Posttraumatic orbital reconstruction has been a challenging mission for decades in craniomaxillofacial surgery. Complications like enophthalmos, diplopia and gaze obstacles emerge when orbital trauma occurs, affecting people's daily life as well as their appearance. Advances in technology and research gained through years of experience has provided us with a greater understanding of the changes following trauma, as well as providing us with a variety of filling materials that we can choose from to handle the deformities. However, the best type of material for repair of orbital deformities remains controversial. This paper reviewed approximately 60 articles discussing materials used in orbital reconstruction or soft tissue defect filling in the past years, with the aim of giving a comprehensive overview of the advantages and disadvantages of materials used in this field so as to help surgeons to make a better choice.

Surgical Management of Orbital Fractures Using X-ray Film Plate: a Retrospective Case Series

“…All the patients of OBF should be advised to avoid blowing the nose as there have been reports of orbital emphysema and cellulites following this manoeuvre in the cases with orbital injury. 14,15,16 We counselled all the patients to refrain from blowing the nose and started them on broad-spectrum antibiotics. The zero incidence of peri-orbital emphysema or infection in our case series can be attributed to this precaution.…”

The Evaluation of Complications of Titanium Mesh Reconstruction in Orbital Floor Fractures

“…Titanium mesh has been approved by the Food and Drug Administration (FDA) since 1984, and now is accepted throughout the world to be used in the craniomaxillofacial surgery, especially in large defects (Ling-Xiao Ye et al, 2016). Titanium plates are thin, stiff and easy to contour.…”

Dermis Fat Graft: A Utility Tool for Soft Tissue Augmentation in Orbital Fractures

“…Its incidence ranges from 18% to 50% of all Cranio-maxillofacial traumas. 1 The eye is well protected in a bony cage by the strong orbital rims, but the orbital floor and the medial wall are comparatively thinner. These thin walls act as crumple zones and undergo gross comminution following orbital trauma leading to functional as well as aesthetic deformities.…”

“…2 Various biomaterials, including autografts, allografts, xenografts, alloplastic implants such as titanium implants, A biological ceramics, and composites, have been used for correction of bony defects. 1 The alloplastic orbital implants have been developed to prevent postoperative orbital volume and soft tissue deficit. Solid implants risk disturbing ocular motility and compromising neurovascular function, particularly of the optic nerve.…”

“…Silicone oil was the first injectable material placed into the orbit for volume augmentation but was associated with complications like extrusion, immigration of implant, and infections. 1 Since the end of the 19 th century, autologous fat grafts (either free fat or dermal fat graft) have been used to handle various softtissue defects. Neuber first used fat autografting to correct facial defects in 1893.…”