The Role of Resorbable Plate and Artificial Bone Substitute in Reconstruction of Large Orbital Floor Defect

It is essential to reduce and reconstruct bony defects adequately in large orbital floor fracture and defect. Among many reconstructive methods, alloplastic materials have attracted attention because of their safety and ease of use. We have used resorbable plates combined with artificial bone substitutes in large orbital floor defect reconstructions and have evaluated their long-term reliability compared with porous polyethylene plate. A total of 147 patients with traumatic orbital floor fracture were included in the study. Surgical results were evaluated by clinical evaluations, exophthalmometry, and computed tomography at least 12 months postoperatively. Both orbital floor height discrepancy and orbital volume change were calculated and compared with preoperative CT findings. The average volume discrepancy and vertical height discrepancies were not different between two groups. Also, exophthalmometric measurements were not significantly different between the two groups. No significant postoperative complication including permanent diplopia, proptosis, and enophthalmos was noted. Use of a resorbable plate with an artificial bone substitute to repair orbital floor defects larger than 2.5 cm2in size yielded long-lasting, effective reconstruction without significant complications. We therefore propose our approach as an effective alternative method for large orbital floor reconstructions.

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Cranioplasty after decompressive craniectomy: is there a rationale for an initial artificial bone-substitute implant? A single-center experience after 631 procedures

Journal of Neurosurgery ◽

10.3171/2015.4.jns159 ◽

2016 ◽

Vol 124 (3) ◽

pp. 710-715 ◽

Cited By ~ 42

Author(s):

Falko Schwarz ◽

Pedro Dünisch ◽

Jan Walter ◽

Yasser Sakr ◽

Rolf Kalff ◽

...

Keyword(s):

Risk Factors ◽

Bone Resorption ◽

Decompressive Craniectomy ◽

Bone Substitute ◽

Older Patients ◽

Artificial Bone ◽

Flap Necrosis ◽

Discrimination Analysis ◽

Bone Necrosis

OBJECT The complication rate for cranioplasty after decompressive craniectomy is higher than that after other neurosurgical procedures; aseptic bone resorption is the major long-term problem. Patients frequently need additional operations to remove necrotic bone and replace it with an artificial bone substitute. Initial implantation of a bone substitute may be an option for selected patients who are at risk for bone resorption, but this cohort has not yet been clearly defined. The authors’ goals were to identify risk factors for aseptic bone flap necrosis and define which patients may benefit more from an initial bone-substitute implant than from autograft after craniectomy. METHODS The authors retrospectively analyzed 631 cranioplasty procedures (503 with autograft, 128 with bone substitute) by using a stepwise multivariable logistic regression model and discrimination analysis. RESULTS There was a significantly higher risk for reoperation after placement of autograft than after placement of bone substitute; aseptic bone necrosis (n = 108) was the major problem (OR 2.48 [95% CI1.11–5.51]). Fragmentation of the flap into 2 or more fragments, younger age (OR 0.97 [95% CI 0.95–0.98]; p < 0.001), and shunt-dependent hydrocephalus (OR 1.73 [95% CI1.02–2.92]; p = 0.04) were independent risk factors for bone necrosis. According to discrimination analysis, patients younger than 30 years old and older patients with a fragmented flap had the highest risk of developing bone necrosis. CONCLUSIONS Development of bone flap necrosis is the main concern in long-term follow-up after cranioplasty with autograft. Patients younger than 30 years old and older patients with a fragmented flap may be candidates for an initial artificial bone substitute rather than autograft.

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Radiologic and Facial Morphologic Long-Term Results in Treatment of Orbital Floor Fracture With Flexible Absorbable Alloplastic Material

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2012.05.023 ◽

2012 ◽

Vol 70 (10) ◽

pp. 2375-2385 ◽

Cited By ~ 8

Author(s):

Marcus Gerressen ◽

Simone Gilleßen ◽

Dieter Riediger ◽

Frank Hölzle ◽

Ali Modabber ◽

...

Keyword(s):

Long Term Results ◽

Orbital Floor ◽

Alloplastic Material ◽

Orbital Floor Fracture

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The Role of Risk Related Knowledge in the Diffusion of Internet Innovations

Journal of Information & Knowledge Management ◽

10.1142/s0219649210002474 ◽

2010 ◽

Vol 09 (01) ◽

pp. 31-40 ◽

Cited By ~ 5

Author(s):

Zakaria I. Saleh ◽

Emad Abushanab

Keyword(s):

Diffusion Of Innovation ◽

User Satisfaction ◽

Perceived Risk ◽

High Volume ◽

Ease Of Use ◽

Internet Technology ◽

The Internet ◽

Online Purchases

Several variables can influence the adoption of innovation. Human Computer Interaction research has focused on ease of use as the prime determinate of user satisfaction and adoption. This study explores the issues that influence the adoption, and further examines the knowledge of perceived risk as an influence. The study examines existing theory as it pertains to the diffusion of innovation from the perspective of the Internet, and assesses the extent to which Internet technology can be used in building long-term consumer relationships. Despite the high volume of shopping done on the Internet each day, many consumers fail to make online purchases because of continued reluctance to engage in transactions with intermediaries that are not familiar and trusted. Based on the previous studies, this study posits that perceived risk for security of online transactions is one of the factors influencing online purchasing behaviour, and has an effect on the continued use.

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