Arch Plast Surg.  2019 Sep;46(5):421-425. 10.5999/aps.2019.00703.

A novel technique for placing titanium mesh with porous polyethylene via the endoscopic transnasal approach into the orbit for medial orbital wall fractures

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea.
  • 2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
  • 3TAE Plastic Surgery Clinic, Busan, Korea.
  • 4Busan Cancer Center, Pusan National University Hospital, Busan, Korea. taewoo.kang@pusan.ac.kr

Abstract

BACKGROUND
The endoscopic transnasal approach is widely used for reconstructing the medial orbital wall by filling it with a silicone sheet or Merocel, but this technique has the disadvantage of retaining the packing for a long time. To overcome this drawback, a method of positioning an absorbable plate in the orbit has been introduced, but there is a risk of defect recurrence after the plate is absorbed. Here, the authors report the results of a novel surgical technique of placing a nonabsorbable titanium mesh with porous polyethylene into the orbit through the endoscopic transnasal approach.
METHODS
Fourteen patients underwent surgery using the endoscopic transnasal approach. Preoperative computed tomography (CT) was used to calculate the size of the bone defect due to the fracture, and the titanium mesh was designed to be shorter than the anteroposterior length of the defect and longer than its height. The titanium mesh was inserted into the orbit under an endoscopic view. The authors then confirmed that the titanium mesh supported the orbital contents by pressing the eyeball and finished the operation. Immediately after surgery, CT results were evaluated.
RESULTS
Postoperative CT scans confirmed that the titanium mesh was well-inserted and in the correct position. All patients were discharged without any complications.
CONCLUSIONS
We obtained satisfactory results by inserting a titanium mesh with porous polyethylene into the orbit via the transnasal approach endoscopically.

Keyword

Wound and injuries; Endoscopy; Orbit; General surgery; Titanium

MeSH Terms

Endoscopy
Humans
Methods
Orbit*
Polyethylene*
Recurrence
Silicon
Silicones
Titanium*
Tomography, X-Ray Computed
Polyethylene
Silicon
Silicones
Titanium
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