The Inferior Orbital Wall Reconstruction by Titanium Micro-mesh Remodeling

Kim, Han Koo; Choi, Min Seok; Kim, Woo Seob; Bae, Tae Hui

Abstract

PURPOSE
The inferior orbital wall is the most vulnerable to injury and inadequate reconstruction of inferior orbital fracture result in postoperative complications include enophthalmos, ocular dystopia and diplopia. Although the anatomical reconstruction of the inferior orbital wall is necessary to prevent these complications, the complexity of inferior orbital wall makes it difficult. We fabricated and remodeled the titanium micro-mesh plate for the anatomical reconstruction of inferior orbital wall.
METHODS
Twenty-nine patients with inferior orbital wall blow-out fracture were operated and twelve of them presented large extensive fracture. We intraoperatively fabricated and remodeled the Titanium-micro mesh to angulated lazy S shape similar to contralateral uninjured orbit. The preoperative and postoperative facial CT scan verified the 3-dimensional and anatomical reconstruction of the fractures. The mean follow-up was 19.7 months and postoperative complications was evaluated.
RESULTS
All cases showed the exact anatomical reconstruction, but there were minor complications in two cases. one patient had postoperative diplopia until 3months after surgery and the other patient had persistent enophthalmos(2mm), but no further surgical correction was required.
CONCLUSION
The comprehensive understanding of orbital convexity is the most important factor for anatomical reconstruction of inferior orbital fracture. We could prevent postoperative complications after inferior orbital wall reconstruction by intraoperative fabrication and anatomical remodeling of Titanium micro-mesh.