Pure orbital blowout fractures reconstructed with autogenous bone grafts: functional and aesthetic outcomes

Kronig, Sophia A J; Mooren, R.J.G. van der; Strabbing, Elske M.; Stam, Liselotte H. M.; Tan, Jing; Jongh, Eva de; Wal, K.G.H. van der; Paridaens, Dion

doi:10.1016/j.ijom.2015.11.024

Cited by 13 publications

(21 citation statements)

References 29 publications

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“…Bone, cartilaginous and fascial autografts are the most suitable materials for orbital floor reconstruction due to their non-allergenic and non-carcinogenic nature, and also high biocompatibility. [12,13] However, there are disadvantages of using autografts, such as increased duration of surgery, donor site morbidity, difficulties in shaping the graft and unpredictable graft resorption rate. [13,14] Alloplastic implants are consistent synthetic materials.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of orbital floor fractures using a porous polyethylene implant: outcomes in the early, intermediate and late postoperative periods

Özkaya

Erçöçen

2020

ENT Updates

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Objective: The porous polyethylene implant (PPEI) is one of the most commonly used alloplastic materials in cranio-maxillofacial surgery. It is widely preferred because of its biocompatible, durable, flexible and thin nature as well as for its low complication rates. The purpose of the present study was to review the clinical and surgical outcomes of PPEI usage for orbital floor fractures. Methods: The present study included 76 patients who underwent orbital floor fracture reconstruction using PPEI between July 2000 and July 2018. All demographic characteristics of the patients were recorded and the patients were questioned and/or examined whether there was any complaint or complication secondary to the surgery. Results: The mean age of the patients was 35.2 years with a male predominance. The most common causes of injury were in-vehicle traffic accidents, falls, physical assaults and pedestrian accidents, respectively. 73 patients had other concomitant fractures of the facial bones along with the orbital floor fracture. The mean time between the injury and the surgical repair was eight days. Scleral show was observed in two patients (2.6%) due to scar contracture of the subciliary incision whereas one patient had surgical removal of the PPEI. Conclusion: The present study revealed that PPEI is a reliable and flexible material for the reconstruction of orbital floor fractures with a low risk of complications. To prevent or minimize postoperative complications, the orbital septum must be repaired meticulously.

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Section: Discussionmentioning

confidence: 99%

Reconstruction of orbital floor fractures using a porous polyethylene implant: outcomes in the early, intermediate and late postoperative periods

Özkaya

Erçöçen

2020

ENT Updates

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“…Engineering techniques, including a rapid prototyping (RP) model, a mirrored patient-specific implant (PSI), and 3D printing technology, have been introduced in medicine to obtain a more precise implant contour (Hassfeld & Muhling, 2001;Metzger et al 2006;Lieger et al 2010;Stoor et al 2014;Kozakiewicz, 2014;Gander et al 2015;Oh et al 2016;Cha et al 2017;Kim et al 2017;Vignesh et al 2017) RP and a mirrored PSI are highly applicable to surgery because they easily produce a complex structure similar to an orbital cavity. Aseptic treatment of the RP contour model is followed by intra-operative molding and bending of the implant material, such as titanium, to obtain a customized implant with a precise contour that is applied at the fracture site (Vehmeijer et al 2016;Kronig et al 2016;Oh et al 2016;Kim et al 2017). A mirrored PSI is obtained by 3D reconstruction of the fractured orbit using the mirrored normal orbit as a template (Gander et al 2015).…”

Section: Discussionmentioning

confidence: 99%

Restoration of the inferomedial orbital strut using a standardized three‐dimensional printing implant

Kim

Lee

et al. 2019

Journal of Anatomy

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The inferomedial orbital strut (IOS) is the thin bony junction of the orbital medial wall and floor. Its fracture is common and leads to serious complications, including enophthalmos, globe dystopia and diplopia. However, anatomical restoration of the IOS is challenging owing to reduced structural support; sound anatomical background and accurate implants are therefore essential. The aim of the present study was to incorporate data from cadaveric orbit anatomy into three-dimensional (3D) printing technology and to reconstruct the complex orbital fracture elaborately. After averaging the data from computed tomography (CT) images of 100 adult cadavers, the dimensions of the IOS were extracted, and a tangent sphere was created using a computeraided design program. The curves were compared with the CT data of 10 adult patients from the simulation test. Based on these data, a standardized 3D implant, 1.15 mm thick, was designed using polycaprolactone. The implant was placed in five patients with complex orbital fractures. The radius of the sphere in contact with the orbit, measuring 33.54 mm, was confirmed to be appropriate. A comparison between the normal side volume (V0) and the postoperative volume (V post ) showed that they were statistically similar. Furthermore, a comparison between V0 and the preoperative volume (V pre ), and V post compared with V pre also showed a statistically significant difference (P < 0.05). On follow-up, the preoperative ocular symptoms were resolved. The orbital data obtained from 100 cadavers provided standardized orbital anatomy, and 3D printed implants were created. The implants were anatomically accurate with regard to the orbital cavity and adequately covered the simulation model. The implant also showed satisfactory results when applied clinically in actual patients.

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“…Nos casos em que a cirurgia é indicada, alguns materiais podem ser utilizados para reconstrução da órbita, variando entre enxertos e materiais aloplásticos. Kronig et al 4 (2016) realizaram um estudo com a reconstrução feita com enxerto ósseo autógeno e observaram que, com seguimento de um ano, nenhum dos pacientes submetidos ao procedimento apresentou enoftalmo, quando todas as paredes envolvidas foram reconstruídas; já, nos pacientes que não tiveram a parede medial reconstruída, 29% ainda apresentavam enoftalmo após o período de tempo.…”

Section: Discussionunclassified

“…Os pacientes que apresentam fraturas de órbita costumam ter como sinais clínicos o edema e a equimose periorbitários, assimetria das órbitas, limitação da motilidade ocular, ptose palpebral, enoftalmo e hipoftalmo. É recorrente, também, que os pacientes apresentem sintomas como parestesia na região infraorbitária e diplopia 4 .…”

Section: Introductionunclassified

Reconstruções orbitárias: relato de três casos

Daltro¹,

Jesus

Oliveira³

et al. 2018

Rev. da Fac. de Odontologia, UPF

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Objetivo: este trabalho visa a apresentar uma série detrês casos clínicos com diferentes condutas para tratamentode fraturas de assoalho de órbita. Relato decasos: no primeiro caso, o paciente, sexo masculino,foi vítima de ferimento por arma de fogo, apresentandodiplopia, trismo e queixas estéticas. A conduta seguidafoi reconstrução do assoalho da órbita com telade titânio isolada. No segundo caso, o paciente, sexomasculino, foi vítima de acidente motociclístico, apresentandodiplopia e enoftalmo. A conduta seguida foireconstrução utilizando associação de tela de titâniocom polimetilmetacrilato (PMMA). No terceiro caso, opaciente, sexo masculino, foi vítima de acidente automobilístico,apresentando enoftalmo, diplopia e perdade projeção malar. A conduta seguida foi reconstruçãoutilizando associação da tela de titânio com PMMA.Nos três casos, os pacientes evoluíram com melhora doquadro clínico, mostrando-se satisfeitos com os resultadosestético e funcional. Considerações finais: emboraas condutas sejam diversificadas e variem entre cirurgiões,é importante o conhecimento das técnicas e dosmateriais a serem utilizados, bem como das vantagense desvantagens de cada intervenção, sendo de fundamentalimportância também a avaliação de cada casoem particular. Palavras-chave: Face. Fraturas ósseas. Órbita.

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Pure orbital blowout fractures reconstructed with autogenous bone grafts: functional and aesthetic outcomes

Cited by 13 publications

References 29 publications

Reconstruction of orbital floor fractures using a porous polyethylene implant: outcomes in the early, intermediate and late postoperative periods

Reconstruction of orbital floor fractures using a porous polyethylene implant: outcomes in the early, intermediate and late postoperative periods

Restoration of the inferomedial orbital strut using a standardized three‐dimensional printing implant

Reconstruções orbitárias: relato de três casos

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