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KMID : 1033720190200030164
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Archives of Craniofacial Surgery
2019 Volume.20 No. 3 p.164 ~ p.169
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Reconstruction of extended orbital floor fracture using an implantation method of gamma-shaped porous polyethylene
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Hwang Woo-Suk
Kim Jin-Woo
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Abstract
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Background: The conventional surgical method for reconstructing orbital floor fractures involves restoration of orbital continuity by covering an onlay with a thin material under the periorbital region. However, in large orbital floor fractures, the implant after inserting is often dislocated, leading to malposition. This study aimed to propose a novel implanting method and compare it with existing methods.
Methods: Among patients who underwent surgery for large orbital floor fractures, 24 who underwent the conventional onlay implanting method were compared with 21 who underwent the novel γ implanting method that two implant sheets were stacked and bent to resemble the shape of the Greek alphabet γ. When inserting a γ-shaped implant, the posterior ledge of the orbital floor was placed between the two sheets and the bottom sheet was impacted onto the posterior wall of the maxilla to play a fixative role while the top sheet was placed above the residual orbital floor to support orbital contents. Wilcoxon signed-rank test and Mann-Whitney U test were used for data analyses.
Results: Compared to the conventional onlay method, the gamma method resulted in better restoration of orbital contents, better improvement of enophthalmos, and fewer revision surgeries.
Conclusion: Achieving good surgical outcomes for extended orbital floor fractures is known to be difficult. However, better surgical outcomes could be obtained by using the novel implantation method of impacting a γ-shaped porous polyethylene posteriorly.
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KEYWORD
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Operative, Orbital fractures, Orbital implant, Surgical procedure
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