Resorbable mesh in the treatment of orbital floor fractures. 2001

L H Hollier, and N Rogers, and E Berzin, and S Stal
Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas, USA.

A variety of materials have been used to reconstruct defects of the orbital floor. Autogenous materials such as bone and cartilage have the obvious drawback of the necessary donor site, whereas alloplastic implants carry the potential risk of infection, particularly when in communication with the maxillary sinus. Consequently, there has been interest in the use of resorbable alloplastic material that acts as a barrier until completely degraded. In this series, a total of 12 patients with orbital defects larger than 1 cm2 were treated by the placement of a resorbable mesh plate of polyglycolic and polylactic acid (Lactosorb). Of the total of 12 patients treated, 3 were lost to follow-up. Of the remaining 9 patients, the mean follow-up was 6 months, with the longest follow-up being 15 months and the shortest 1 month. Two patients developed enophthalmos. In each case, this measured 2 mm using Hertel exophthalmometry, and was present in the early postoperative period (less than 1 month). The cause of the enophthalmos in both patients was found to be a technical error in placement of the mesh. One patient developed an inflammatory reaction along the infraorbital rim requiring implant removal. This occurred at 7 months. From the above series, it is concluded that resorbable mesh is an acceptable material for reconstruction of the orbital floor in selected patients. It is believed that larger floor defects are better suited for nonresorbable alloplastic reconstruction, and that placement of the mesh over the infraorbital rim is unnecessary and places the patient at risk for a local inflammatory reaction.

UI MeSH Term Description Entries
D009915 Orbit Bony cavity that holds the eyeball and its associated tissues and appendages. Eye Socket,Eye Sockets,Orbits,Socket, Eye,Sockets, Eye
D009917 Orbital Fractures Fractures of the bones in the orbit, which include parts of the frontal, ethmoidal, lacrimal, and sphenoid bones and the maxilla and zygoma. Blow Out Fracture,Blow-Out Fractures,Fractures, Blow-Out,Orbital Fracture,Blow Out Fractures,Blow-Out Fracture,Fracture, Blow Out,Fracture, Blow-Out,Fracture, Orbital,Fractures, Blow Out,Fractures, Orbital,Out Fracture, Blow,Out Fractures, Blow
D010000 Osteitis Inflammation of the bone. Bone Inflammation,Inflammation, Bone
D011100 Polyglycolic Acid A biocompatible polymer used as a surgical suture material. Polyglycolide,Biofix,Dexon (Polyester),Dexon-S,Dexon S,DexonS
D011108 Polymers Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., BIOPOLYMERS; PLASTICS). Polymer
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D003941 Diagnostic Techniques, Ophthalmological Methods and procedures for the diagnosis of diseases of the eye or of vision disorders. Diagnostic Technic, Ophthalmological,Diagnostic Technics, Ophthalmologic,Diagnostic Technics, Ophthalmological,Diagnostic Technique, Ophthalmological,Diagnostic Techniques, Ophthalmologic,Ophthalmological Diagnostic Technic,Ophthalmological Diagnostic Technics,Ophthalmological Diagnostic Technique,Ophthalmological Diagnostic Techniques,Technic, Ophthalmological Diagnostic,Technics, Ophthalmological Diagnostic,Technique, Ophthalmological Diagnostic,Techniques, Ophthalmological Diagnostic,Diagnostic Technic, Ophthalmologic,Diagnostic Technique, Ophthalmologic,Ophthalmologic Diagnostic Technic,Ophthalmologic Diagnostic Technics,Ophthalmologic Diagnostic Technique,Ophthalmologic Diagnostic Techniques,Technic, Ophthalmologic Diagnostic,Technics, Ophthalmologic Diagnostic,Technique, Ophthalmologic Diagnostic,Techniques, Ophthalmologic Diagnostic
D004774 Entropion The turning inward (inversion) of the edge of the eyelid, with the tarsal cartilage turned inward toward the eyeball. (Dorland, 27th ed) Entropions
D005143 Eyelids Each of the upper and lower folds of SKIN which cover the EYE when closed. Eyelid
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

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