Titanium Mesh Reconstruction of Orbital Roof Fracture with Traumatic Encephalocele: A Case Report and Review of Literature

Abstract

Orbital roof fractures are rare. Traumatic encephaloceles in the orbital cavity are even rarer, with only 21 cases published to date. Orbital roof fractures are generally encountered in males between 20 and 40 years of age following automobile collision. We report a case of an orbital roof fracture with traumatic encephalocele into the left orbit. Early diagnosis and treatment are very important because the raised intraorbital pressure may irreversibly damage the optic nerve. Computed tomography with 3-D reconstruction, the imaging modality of choice, showed the displaced fracture fragment deep into the orbit. Reconstruction of the orbital roof should be performed in every case. We used an extracranial approach to elevate the fracture with titanium mesh to stabilize the fragment. The cosmetic results were excellent but delay in treatment was responsible for delayed recovery of vision. The case report is followed by a brief overview of orbital roof fractures including pertinent review of literature.

Long-Term Results of Orbital Roof Repair with Titanium Mesh in a Case of Traumatic Intraorbital Encephalocele: A Case Report and Review of Literature

“…There are two approaches to the orbital roof: the transcranial and the extracranial approach. 20 The usual surgical technique is the resection of herniated contused brain tissue and reconstruction of the bony orbital roof (using autologous bone or alloplastic implant) with dural closure via transcranial approach to the frontobasal region. 23,24,27,28 Reconstruction is an important step of the surgery to prevent later recurrence and to ensure acceptable cosmetic results.…”

Use of 3D Printing Model for the Management of Fibrous Dysplasia: Preliminary Case Study

“…On the contrary, the titanium material is known to have very good biocompatibility and has been actually used for more than 30 years in craniofacial surgery (12). Of course, given the nature of the titanium materials, it also has a possibility of the exposure or infection especially after the radiation therapy.…”

Natural Course of Orbital Roof Fractures

“…5 Usually, it concerns males between 20 and 40 years old who are involved in traffic accidents, violence, falling, sports, and work-related accidents or fireworks. 2,[10][11][12] Kim et al, 3 Gazioğlu et al, 7 and Penfold et al 13 recommend early reconstruction in every case of orbital roof fractures, to reduce intracranial and ocular complications. Variable autologous and alloplastic materials are reposted to reconstruct the orbit.…”