scholarly journals Autogenous mucochondral-osteal nasoseptal graft for reconstruction of orbital floor: a preliminary study

2021 ◽  
Vol 7 (9) ◽  
pp. 1517
Author(s):  
B. M. Rudagi ◽  
Rishabh Jain ◽  
Shahbaaz Naikwade ◽  
Gaurav Bhavar
Keyword(s):  
Postoperative Radiotherapy ◽  
Vascular Supply ◽  
High Rate ◽  
Orbital Floor ◽  
Inferior Wall ◽  
Ocular Motility ◽  
Structural Part ◽  
Operative Outcomes ◽  
Orbital Floor Reconstruction ◽  
Flap Design

<p class="abstract">Resection of malignant sinonasal/skull base tumors that erode the orbital floor often result in large defects. We describe a technique for orbital floor reconstruction using a structural pedicled mucochondral-osteal nasoseptal flap (PMCONSF) that includes both soft tissue and bony-cartilaginous components with a continuous pedicled vascular supply. Case presentation was 11 patients having tumors associated with midface requiring maxillectomy and removal of inferior wall of orbit were included. Reconstruction of floor of orbit was done using PMCONSF. Post-operative outcomes of the techniques were studied. In all 11 cases reconstruction of floor of orbit was done using pedicled nasoseptal cartilage and in none of the cases communication of the orbital content with maxillary sinus was encountered. Complete ophthalmic examination revealed no significant diplopia, no entrapment of ocular structures with good ocular motility. Adequate reconstruction of the orbital floor is crucial to maintaining long-term ocular function. The PMCONSF offers great flexibility in flap design as well as a high rate of success. The bony-cartilaginous component offers a rigid structural part to the orbital floor, eliminating the functional defects that can occur from anatomical changes. The pedicled vascular supply helps assist in graft integration, limiting the potential for graft rejection or necrosis following postoperative radiotherapy. We believe that this graft offers a viable alternative to existing methods for orbital reconstruction in patients with large orbital floor defects, especially for cases in which adjuvant postoperative radiotherapy is anticipated.</p>

scholarly journals Orbital Floor Reconstruction: A Comparison of Outcomes between Absorbable and Permanent Implant Systems

2019 ◽  
Vol 12 (3) ◽  
pp. 193-198 ◽  
Author(s):  
Marc A. Polacco ◽  
Peter W. Kahng ◽  
Chad K. Sudoko ◽  
Benoit J. Gosselin
Keyword(s):  
Fracture Repair ◽  
Infraorbital Nerve ◽  
Orbital Floor ◽  
Ocular Motility ◽  
Absorbable Implants ◽  
Orbital Floor Fracture ◽  
Orbital Floor Reconstruction ◽  
Permanent Implants ◽  
Absorbable Implant ◽  
Ti Mesh

There are distinct advantages and disadvantages between bioresorbable and permanent implants in orbital floor reconstruction. Our aim was to compare the outcomes and complications of resorbable implants and permanent implants in orbital floor fracture repair. A retrospective chart review was performed on all patients who underwent orbital floor fracture repair at a rural, tertiary care center from 2011 through 2016. Main outcome measures included improvement in diplopia, ocular motility, enophthalmos, hypoglobus, and infraorbital nerve sensation. A total of 87 patients underwent orbital floor reconstruction. After exclusion criteria were applied, 22 patients were included in the absorbable implant cohort, and 20 patients in the nonabsorbable implant cohort. All absorbable implants were composed of poly L-lactide/poly glycolide/poly D-lactide (PLL/PG/PDL), and nonabsorbable implants included both titanium/porous polyethylene (Ti/PPE) composite and titanium (Ti) mesh. Mean fracture surface area was 2.1 cm2 (standard deviation [SD]:± 0.9 cm2, range: 0.4–3.6 cm2) for the absorbable implant group and 2.3 cm2 (SD: ± 1.1 cm2, range: 0.6–4.4 cm2) for the nonabsorbable implant group ( p = 0.58). There were no significant differences in diplopia, ocular motility, enophthalmos, hypoglobus, and infraorbital nerve sensation between absorbable and nonabsorbable implant groups. The mean follow-up time for absorbable and nonabsorbable implant groups was 622 (SD ± 313) and 578 (SD ± 151) days respectively ( p = 0.57). For moderate-size orbital floor fracture repairs, there is no difference in outcomes between absorbable implants consisting of PLL/PG/PDL and nonabsorbable implants consisting of Ti mesh or Ti/PPE combination.

Implant Materials Used for Orbital Floor Reconstruction

2020 ◽  
Vol 11 (1) ◽  
pp. 1266
Author(s):  
Mohamed Esmail Khalil ◽  
Mohamed Farag Khalil ◽  
Raafat Mohyeldeen Abdelrahman ◽  
Ahmed Mohamed Kamal Elshafei ◽  
Tamer Ismail Gawdat
Keyword(s):  
Orbital Floor ◽  
Implant Materials ◽  
Orbital Floor Reconstruction ◽  
Materials Used

Orbital Floor Reconstruction With Ethyl-2-Cyanoacrylate

2015 ◽  
Vol 74 (2) ◽  
pp. 195-198 ◽  
Author(s):  
Hitoshi Nemoto ◽  
Yoshinori Ito ◽  
Yoshiaki Kasai ◽  
Naoki Maruyama ◽  
Naohiro Kimura ◽  
...  
Keyword(s):  
Orbital Floor ◽  
Orbital Floor Reconstruction

Augmented Reality Assisted Orbital Floor Reconstruction

2021 ◽  
Author(s):  
Yihao Liu ◽  
Ehsan Azimi ◽  
Nikhil Dave ◽  
Cecil Qiu ◽  
Robin Yang ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Orbital Floor ◽  
Orbital Floor Reconstruction

Management of the Orbital Floor in Silent Sinus Syndrome

2003 ◽  
Vol 17 (2) ◽  
pp. 97-100 ◽  
Author(s):  
Robert D. Thomas ◽  
Scott M. Graham ◽  
Keith D. Carter ◽  
Jeffrey A. Nerad
Keyword(s):  
Ct Scan ◽  
Maxillary Sinus ◽  
Current Trend ◽  
Ct Scanning ◽  
Volumetric Analysis ◽  
Orbital Floor ◽  
Second Stage ◽  
Silent Sinus Syndrome ◽  
Orbital Floor Reconstruction ◽  
Preoperative Ct

Background Enophthalmos in a patient with an opacified hypoplastic maxillary sinus, without sinus symptomatology, describes the silent sinus syndrome. A current trend is to perform endoscopic maxillary antrostomy and orbital floor reconstruction as a single-staged operation. A two-staged approach is performed at our institution to avoid placement of an orbital floor implant in the midst of potential infection and allow for the possibility that enophthalmos and global ptosis may resolve with endoscopic antrostomy alone, obviating the need for orbital floor reconstruction. Methods A retrospective review identified four patients with silent sinus syndrome evaluated between June 1999 and August 2001. Patients presented to our ophthalmology department with ocular asymmetry, and computerized tomography (CT) scanning confirmed the diagnosis in each case. Results There were three men and one woman, with ages ranging from 27 to 40 years. All patients underwent endoscopic maxillary antrostomy. Preoperative enophthalmos determined by Hertel's measurements ranged from 3 to 4 mm. After endoscopic maxillary antrostomy, the range of reduction in enophthalmos was 1–2 mm. Case 2 had a preoperative CT scan and a CT scan 9 months after left endoscopic maxillary antrostomy. Volumetric analysis of the left maxillary sinus revealed a preoperative volume of 16.85 ± 0.06 cm3 and a postoperative volume of 19.56 ± 0.07 cm3. This represented a 16% increase in maxillary sinus volume postoperatively. Orbital floor augmentation was avoided in two patients because of satisfactory improvement in enophthalmos. In the other two patients, orbital reconstruction was performed as a second-stage procedure. There were no complications. Conclusion Orbital floor augmentation can be offered as a second-stage procedure for patients with silent sinus syndrome. Some patients’ enophthalmos may improve with endoscopic antrostomy alone.

Is Orbital Floor Reconstruction With Titanium Mesh Safe?

2017 ◽  
Vol 28 (7) ◽  
pp. e692-e694 ◽  
Author(s):  
Omar Bakr Hazm Al-Khdhairi ◽  
Saif Saadedeen Abdulrazaq
Keyword(s):  
Orbital Floor ◽  
Titanium Mesh ◽  
Orbital Floor Reconstruction

scholarly journals The Dilemma of Reconstructive Material Choice for Orbital Floor Fracture: A Narrative Review

Medicines ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 6
Author(s):  
Akash Sivam ◽  
Natalie Enninghorst
Keyword(s):  
Disease Transmission ◽  
Narrative Review ◽  
Orbital Floor ◽  
Alloplastic Materials ◽  
Complex Anatomy ◽  
Orbital Floor Fractures ◽  
Orbital Floor Reconstruction ◽  
Material Choice ◽  
Properties Of Materials ◽  
Catastrophic Disease

The aim of this study is to present a narrative review of the properties of materials currently used for orbital floor reconstruction. Orbital floor fractures, due to their complex anatomy, physiology, and aesthetic concerns, pose complexities regarding management. Since the 1950s, a myriad of materials has been used to reconstruct orbital floor fractures. This narrative review synthesises the findings of literature retrieved from search of PubMed, Web of Science, and Google Scholar databases. This narrative review was conducted of 66 studies on reconstructive materials. Ideal material properties are that they are resorbable, osteoconductive, resistant to infection, minimally reactive, do not induce capsule formation, allow for bony ingrowth, are cheap, and readily available. Autologous implants provide reliable, lifelong, and biocompatible material choices. Allogenic materials pose a threat of catastrophic disease transmission. Newer alloplastic materials have gained popularity. Consideration must be made when deliberating the use of permanent alloplastic materials that are a foreign body with potential body interactions, or the use of resorbable alloplastic materials failing to provide adequate support for orbital contents. It is vital that surgeons have an appropriate knowledge of materials so that they are used appropriately and reduce the risks of complications.

Using 3D Printing and Mirror Image Modeling in Orbital Floor Reconstruction

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ronald K. Akiki ◽  
Charles C. Jehle ◽  
Joseph Crozier ◽  
Albert S. Woo
Keyword(s):  
3D Printing ◽  
Mirror Image ◽  
Orbital Floor ◽  
Image Modeling ◽  
Orbital Floor Reconstruction
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