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At least 829 records · Page 46Linked to original sources
PubMed2001

Experience with eyelid-sparing orbital exenteration: the 2000 Tullos O. Coston Lecture.

PURPOSE: To provide data on types of lesions that require orbital exenteration and discuss our experience with exenteration, emphasizing the eyelid-sparing technique. METHODS: The records were reviewed on all patients who underwent orbital exenteration by the senior author and his colleagues. The underlying disease, method of exenteration, healing times, complications, cosmetic outcome, local tumor control, and patient survival were analyzed. RESULTS: Of 56 orbital exenterations, 47 were done by eyelid-sparing technique and 9 by eyelid-sacrificing technique. The 9 tumors of eyelid origin that required exenteration included basal cell carcinoma (4), sebaceous gland carcinoma (3), squamous cell carcinoma (1), and melanoma (1). Four of the eyelid lesions were managed by the eyelid-sparing technique and 5 by the eyelid-sacrificing method. The 24 tumors of conjunctival origin included melanoma (20) and squamous cell carcinoma (4). The eyelid-sparing method was used in 22 of the 24 cases. The 10 primary orbital lesions included melanoma (3), malignant lacrimal gland tumor (3), a rhabdoid tumor, meningioma, Wegener's granulomatosis, and aspergillosis. The eyelid-sparing method was used in 8 of the 10 cases. Among intraocular tumors were uveal melanomas (10) and retinoblastoma (1). The eyelid sparing method was used in all 11. With the eyelid-sparing technique, the mean time from exenteration to wound healing and readiness for a prosthesis was 4 weeks (median, 2 weeks; range, 2 to 24 weeks). With the eyelid-sacrificing technique, the mean time was 68 weeks (median, 34 weeks; range, 2 to 340 weeks). Complications were few and cosmetic results were satisfactory. Local tumor control with exenteration was achieved in 53 of 56 cases, but metastasis occurred in 11 of 20 cases of conjunctival melanoma (55%) and in 6 of 10 patients with uveal melanoma (60%). Metastasis has developed in none of the 3 patients with malignant epithelial tumors of lacrimal gland origin. CONCLUSIONS: Orbital exenteration is an appropriate procedure for orbital involvement by unresectable malignant tumors of the eyelids, conjunctiva, intraocular structures, and orbit. In most of these cases, including about half of tumors originating in the eyelids, an eyelid-sparing exenteration can be used to achieve more rapid healing.

Adolescent↗
PubMed2002

Bovine hydroxyapatite orbital implant: a preliminary report.

PURPOSE: To determine the safety and efficacy of bovine hydroxyapatite as an orbital implant material. METHODS: Prospective, consecutive case series of patients undergoing enucleation, evisceration, or secondary orbital implantation. A motility peg was placed in all consenting candidates. Patients were followed 1 week, 1 month, and several months after surgery for signs of inflammation, infection, extrusion, or other complication. RESULTS: Twenty-seven patients received a bovine hydroxyapatite orbital implant. Magnetic resonance imaging was obtained in 3 patients (3 orbits) approximately 4 weeks after surgery and showed signs of peripheral fibrovascular ingrowth in all three cases. Magnetic resonance imaging was obtained in 9 patients (9 orbits) 4 to 12 months after surgery and showed signs of incomplete fibrovascular ingrowth in 1 of 9 (11%) cases, subtotal fibrovascular ingrowth in 2 of 9 (22%) cases, and complete fibrovascular ingrowth in 6 of 9 (67%) of cases. Complications included postoperative chemosis in 3 cases (11%) and exposure requiring reoperation in 2 cases (7%). Motility peg placement was performed successfully in 5 patients (5 orbits). CONCLUSIONS: Bovine hydroxyapatite appears to be a safe and effective orbital implant material. The material appears to be biocompatible and nonallergenic. Bovine hydroxyapatite allows for fibrovascular integration and motility peg placement.

Adolescent↗
PubMed2003

Complications of supramid orbital implants.

PURPOSE: To determine the incidence and risk factors of complications associated with Supramid orbital implants. METHODS: A retrospective chart review was performed to document complications in a series of 41 patients receiving Supramid implants during orbital reconstruction or fracture repair. Implant size, duration of time between trauma and implant insertion, and history of prior orbital surgery were examined as possible risk factors for the development of complications. RESULTS: Four patients had hemorrhage within the implant capsule. An orbital abscess developed in a single patient. All but one complication appeared 7.8 to 10 years after implant insertion. Patients who had complications had a longer duration of time between trauma and implant insertion than those in whom complications did not occur (P =0.0019). Complications were more frequent among patients with larger (>600 mm2) implants and a history of orbital surgery. CONCLUSIONS: Spontaneous infection or hemorrhage may occur within the capsules of Supramid orbital implants, even many years after surgery. The insertion of larger implants in the late repair of extensive bony orbital defects may predispose patients to these complications. Implant removal and marsupialization of the implant capsule to the maxillary sinus appears to be curative without causing significant postoperative enophthalmos.

Abscess↗
PubMed1985

Orbital volume measurements in enophthalmos using three-dimensional CT imaging.

The purpose of this study was to investigate enophthalmos by measuring the volume of various orbital structures using off-line computer techniques on images generated by a CT scanner. Eleven patients with enophthalmos had CT scans of the orbits consisting of 30 to 40 adjacent 1.5-mm slices. The data from the scans were analyzed on a Nova 830 stand-alone computer system using software programs that allowed measurement of total bony orbital volume, total soft-tissue volume, globe volume, orbital fat volume, neuromuscular tissue volume, and apex-to-globe distance in the horizontal plane. These data were analyzed comparing the volumes in the normal eye with the volumes in the enophthalmic eye in each patient. The analysis demonstrated a statistically significant increase in bony orbital volume in the enophthalmic eye, but the total soft-tissue volume, fat volume, neuromuscular tissue volume, and globe volume were the same as in the normal eye. The apex-to-globe distance, a measure of the degree of enophthalmos, was less in the enophthalmic eye than in the normal eye. These results suggest that in the majority of patients, the cause of posttraumatic enophthalmos is increased bony orbital volume rather than by soft-tissue loss or fat necrosis. (Several patients showed no volume discrepancies, and it is likely that cicatricial contracture is responsible for the enophthalmos in these cases.) This study suggests that the objective of surgery for correction of enophthalmos in patients with a volume discrepancy should be to decrease the volume of the bony orbit and to increase the anterior projection of the globe.

Adipose Tissue↗
PubMed2003

The bioceramic orbital implant: experience with 107 implants.

PURPOSE: To assess the problems associated with the Bioceramic (Aluminum oxide, Al(2)O(3)) orbital implant. METHODS: A consecutive case series of 107 patients receiving a Bioceramic orbital implant by two surgeons over a 3-year period were reviewed. The authors analyzed patient age, type of surgery, size of implant, peg system, follow-up duration, time of pegging, complications encountered, and treatment. RESULTS: Seven patients were lost to follow-up after 2 months, leaving 100 patients who were followed from 3 to 38 months (average, 13.4 months). Three patients died during the follow-up period (one with 2 months' follow-up, one with 7 months' follow-up, and the third with 9 months' follow-up). Implant-related problems occurred in 11 (11%) patients. Discharge occurred in 5 (5%) patients, implant exposure in 2 (2%), socket discomfort in 1 (1%), trochleitis in 1 (1%), and conjunctival thinning in 2 (2%). Peg problems occurred in 11 (34.3%) of 32 pegged patients: discharge in 4 (12.5%) and in 1 patient (3.1%) each, pyogenic granuloma, conjunctiva overgrowing the peg, implant exposure around the sleeve, clicking, accumulation of black material, and broken peg during insertion. Infection did not occur in any patient. CONCLUSIONS: The Bioceramic orbital implant represents an alternative porous orbital implant that is biocompatible with orbital tissues, easy to manufacture, structurally strong, and less expensive than other commercially available porous orbital implants (e.g., Bio-Eye hydroxyapatite implant). Problems encountered with its use are similar to those seen with the Bio-Eye orbital implants but appear to occur less often. The incidence of exposure associated with the Bioceramic implant is less than that reported for the Bio-Eye.

Adolescent↗
PubMed2005

Hertel curve: orbital volume increment and proptosis in a cadaver model.

PURPOSE: This study examined the relation between effective orbital volume increment and proptosis induced by an inflatable orbital implant in a human cadaver orbit. METHODS: A 25-ml inflatable latex balloon was inserted between the periorbita and orbital floor in 15 human cadavers. Hertel measurements were taken for each milliliter over a total 7-ml volume increment. Five trials per orbit for 15 cadavers resulted in 525 data points. RESULTS: Average exophthalmos per milliliter of volume increment was plotted over 7 ml, using 1-ml volume increments. The resultant curve, which was termed a Hertel curve, was linear over 7 ml (R > 99%) and had a slope of 0.62 mm per milliliter of volume increment. CONCLUSIONS: An inflatable orbital implant is an effective tool for introducing a specified amount of volume in the cadaver orbit. The predictable relation between proptosis and volume increment (Hertel curve) may be a useful tool for surgeons in planning the size of an implant required to surgically correct enophthalmos.

Blepharoptosis↗
PubMed2003

Intraorbital encephalocele: an important complication of orbital roof fractures in pediatric patients.

Orbital roof fractures are uncommon, and traumatic intraorbital encephalocele formation is a very rare complication of this type of injury. We treated 43 pediatric patients with orbital roof fractures at our center over a 4-year period. The aim of this study was to retrospectively investigate conditions that may lead to intraorbital encephalocele formation in children with orbital roof fractures. Each case was reviewed, and the cause of injury, associated clinical and computerized tomography findings, the Glasgow Coma Scale score on admission, neurological status, other bodily injuries, hospitalization time and type and width of the orbital roof fracture were recorded. The findings in 6 patients who developed encephaloceles were compared to corresponding findings in the 37 patients who did not develop this complication. A total of 44 orbital roof fractures were diagnosed by axial and coronal computed tomography scanning. Six of the 43 children developed intraorbital encephaloceles in the first month after head trauma. In each of these cases, magnetic resonance imaging demonstrated the intraorbital cystic lesion in communication with the subarachnoid space. The width of each orbital roof fracture was measured on axial and coronal computed tomography slices and was confirmed by measurements during surgery. The width of the fractures in the encephalocele cases ranged from 2-4 mm. Duraplasty and orbitoplasty were performed in all the patients with encephalocele. Pediatric patients with orbital roof fractures that exhibit more than 2 mm diastasis and are associated with frontal cerebral contusion may be at greater risk for developing intraorbital encephalocele. All such cases should be monitored closely and investigated further with magnetic resonance imaging.

Adolescent↗
PubMedDate not supplied

Primary localized orbital amyloidosis: a case report.

PURPOSE: Amyloidosis refers to a heterogeneous group of disorders associated with deposition of chemically distinct fibril proteins. Isolated orbital amyloidosis is a rare condition and requires systemic examination. The authors report a case of amyloid deposit in the orbit whose systemic investigation has been negative. METHODS: A 64-year-old woman presented to the eye clinic with left-sided orbital mass, mild exophthalmos with downward ocular displacement, and ptosis. The patient presented also visual acuity loss and ocular hypertension. No systemic involvement was noted by systemic workup and it confirmed the primary orbital amyloidosis. RESULTS: The patient was subject to full clinical examination, laboratory examinations, orbital echography, magnetic resonance imaging and total body computed tomography scans, rectal mucosa, and temporal artery biopsies. It was necessary to exclude systemic amyloidosis. The presence of amyloid deposits was confirmed by biopsy of orbital mass. The chemical nature of deposit was characterized using light microscopy, immunohistochemistry, and electron microscopy. CONCLUSIONS: Orbital amyloidosis is a very rare disease. It should be considered in the diagnosis of patients with ptosis and exophthalmos. The treatment usually consists of surgical removal of the amyloid mass and follow-up for a likely local recurrence. In our case, mass excision determined the decrease of exophthalmos and intraocular pressure.

Amyloid↗
PubMed2000

Hepatocellular carcinoma metastatic to the orbit.

Orbital metastases of hepatocellular carcinoma are rare. The authors report a case of hepatocellular carcinoma metastatic to the orbit. A 56-year-old woman with hepatitis B infection as confirmed serologic test for hepatitis B surface antigen (HBsAg) demonstrated superior displacement of the left eyeball. The clinical appearance of the patient demonstrated an inferior displacement of the right eye. MRI disclosed an orbital mass that extended toward the lower eyelid and into the temporal fossa with destruction of the lateral orbital wall. Upon subsequent abdominal computed tomographic scans, the primary tumor was found in the liver. A biopsy specimen of the orbit showed trabecular structures with eosinophilic cytoplasm. Bile canaliculi and sinusoids were also seen. The tumor cells showed vesicular nuclei with mitoses. Immunohistochemical markers such as high-molecular-weight keratin and alpha-fetoprotein showed a positive response. However, immunohistochemical markers such as low-molecular-weight keratin and polyclonal carcinoembryonic antigen showed as negative. We diagnosed the tumor as a hepatocellular carcinoma metastatic to the orbit. A review of the pertinent literature disclosed relatively few occurrences of hepatocellular carcinoma metastasizing to the orbit.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Combined fat- and water-suppressed MR imaging of orbital tumors.

BACKGROUND AND PURPOSE: The use of a high-resolution T2-weighted MR sequence, which suppresses signal from both fat and water, has been shown to be highly effective for depicting areas of inflammatory damage within the optic nerve. The ability of this sequence to show neoplastic and inflammatory orbital lesions, which may mimic neuritis, is unknown. This study was designed to examine the characteristics of such a sequence for the investigation of orbital mass lesions. METHODS: Twenty-eight patients with known or suspected mass lesions of the orbit and six healthy volunteers were recruited for study. Imaging was performed with a 1.5-T MR unit. Participants were examined by selective partial inversion recovery (SPIR) sequences with T2-weighted fast spin-echo acquisition, selective partial inversion recovery/fluid attenuated inversion recovery (SPIR/FLAIR) sequences with fast spin-echo acquisition, short tau inversion recovery (STIR) sequences with fast spin-echo acquisition, and SPIR sequences with contrast-enhanced T1-weighted fast spin-echo acquisition. Two neuroradiologists, using a randomised, blinded method, scored images for lesion presence and extent. Lesion extent was defined as the number of images with visible abnormality, and was compared with the standard of reference established at a later date by consensus review of all imaging sequences. The ability of the sequences to show the presence and extent of pathologic lesions was compared. RESULTS: The SPIR/FLAIR sequence showed both the presence and extent of orbital masses significantly better than did either STIR or T2-weighted SPIR sequences (P<.01 and P<.001, respectively). Contrast-enhanced T1-weighted SPIR images ranked better than SPIR/FLAIR images, although the difference failed to reach statistical significance. In the orbital apex, the SPIR/FLAIR technique was superior to all other techniques used. This reflected its ability to distinguish enhancing, pathologic lesions from enhancing, normal anatomy. CONCLUSION: SPIR/FLAIR is an appropriate screening technique for orbital masses and offers significant advantages over currently used fat-suppressed sequences for the investigation of orbital disease.

Adolescent↗
PubMed1999

Mechanisms of orbital floor fractures: a clinical, experimental, and theoretical study.

PURPOSE: The purpose of this study was to investigate the two accepted mechanisms of the orbital blow-out fracture (the hydraulic and the buckling theories) from a clinical, experimental, and theoretical standpoint. METHODS: Clinical cases in which blow-out fractures resulted from both a pure hydraulic mechanism and a pure buckling mechanism are presented. Twenty-one intact orbital floors were obtained from human cadavers. A metal rod was dropped, experimentally, onto each specimen until a fracture was produced, and the energy required in each instance was calculated. A biomathematical model of the human bony orbit, depicted as a thin-walled truncated conical shell, was devised. Two previously published (by the National Aeronautics Space Administration) theoretical structural engineering formulas for the fracture of thin-walled truncated conical shells were used to predict the energy required to fracture the bone of the orbital floor via the hydraulic and buckling mechanisms. RESULTS: Experimentally, the mean energy required to fracture the bone of the human cadaver orbital floor directly was 78 millijoules (mj) (range, 29-127 mj). Using the engineering formula for the hydraulic theory, the predicted theoretical energy is 71 mj (range, 38-120 mj); for the buckling theory, the predicted theoretical energy is 68 mj (range, 40-106 mj). CONCLUSION: Through this study, we have experimentally determined the amount of energy required to fracture the bone of the human orbital floor directly and have provided support for each mechanism of the orbital blow-out fracture from a clinical and theoretical basis.

Adult↗
PubMed2000

MRI dynamic color mapping: a new quantitative technique for imaging soft tissue motion in the orbit.

PURPOSE: To investigate both feasibility and clinical potential of magnetic resonance imaging-dynamic color mapping (MRI-DCM) in measuring the motion of soft tissues in the orbit and in the diagnosis of orbital disorders by detecting changes in motion. METHODS: Sequences of MRI scans were acquired (acquisition time, 5 seconds) in a shoot-stop manner, while the patient fixated at a sequence of 13 gaze positions (8 degrees intervals). Motion was quantified off-line (in millimeters per degree of gaze change) using an optical flow algorithm. The motion was displayed in a color-coded image in which color saturation of a pixel shows the displacement and the hue the displacement's orientation. Six healthy volunteers and four patients (two with an orbital mass and two with acrylic ball implant after enucleation) were studied. RESULTS: The technique was found to be clinically feasible. For a gaze change of 1 degrees, orbital tissues moved between 0.0 and 0.25 mm/deg, depending on the type of tissue and location in the orbit. In the patients with an orbital mass, motion of the mass was similar to that of the medial rectus muscle, suggesting disease of muscular origin. In the enucleated orbits, soft tissue motion was decreased. One eye showed attachment of the optic nerve to the implant, which could be verified by biopsy. CONCLUSIONS: MRI-DCM allows noninvasive and quantitative measurement of soft tissue motion and the changes in motion due to pathologic conditions. In cases in which the diagnosis of a tumor in the apex is in doubt, it may reduce the need for biopsy. In contrast to static computed tomographic (CT) scans and MRIs, it can differentiate between juxtaposition and continuity and may be a new and promising tool in the differential diagnosis of intraorbital lesions.

Adult↗
PubMed1998

Endoscopic exploration of the orbital floor: a technique for transantral grafting of floor blowout fractures.

A cadaveric study was conducted with a twofold purpose--to perform diagnostic transantral endoscopy in pure blowout fractures of the orbital floor and to attempt restoration of bony defects in the orbital floor using the endoscope. Endoscopic visual access of the orbital floor allows precise determination of the fracture size and the presence and extent of entrapped periorbital fasciae. A bony defect was created surgically in the orbital floor of 6 fresh cadaver heads, and a split-thickness calvarial bone graft and an alloplast were used to repair the orbital floor. Grafting of the orbital floor with endoscopic visual access was successful, and the potential risks associated with the traditional eyelid incisions were minimized. The anatomic course of the infraorbital nerve was observed and protected. The study confirmed that endoscopy could be used successfully in obtaining visual access to the orbital floor.

Biocompatible Materials↗
PubMed2002

Histopathologic classification of 3 476 orbital diseases.

OBJECTIVE: To investigate the histopathologic classification and distribution of orbital diseases. METHODS: The authors analyzed 3 476 orbital diseases examined in 1976 - 2000 in the pathology laboratory. RESULTS: Benign orbital diseases were 81.90%. The 10 leading benign orbital diseases were cavernous hemangioma (515), vascular leiomyoma (364), inflammatory pseudotumor (347), dermoid (230), schwannoma (183), meningioma (150), benign mixed tumor of the lacrimal gland (147), mucocele (141), varix (132) and neurofibroma (76). Malignant orbital tumors were 18.10%. The numbers of malignant tnmors were malignant lacrimal gland epithelial tumors (129, 20.51%), rhabdomyosarcoma (75), non-Hodgkin's disease (65), secondary to nasosinus carcinoma (51), metastatic tumor (50), chloroma (32), extraocular extension of retinoblastoma (26) and extraocular extension of choroid malanoma (23). CONCLUSIONS: The vascular tumors and malformations are commonly seen in orbital diseases. The primary malignant tumor in the orbit is the malignant lacrimal gland epithelial tumors.

Eye Neoplasms↗
PubMed2003

[Emergency treatment of post-traumatic orbital emphysema: a case report].

PURPOSE: Orbital emphysema is a common complication of orbital wall fractures (50% of blow-out fractures). It is generally a benign and self-limited condition. However, it may compromise retinal and optic nerve vascularization and therefore requires rapid management. PATIENT AND METHOD: We report a case of traumatic orbital emphysema resulting in ischemic optic neuritis. The orbital emphysema was drained using a 25-gauge needle mounted on a syringe filled with normal saline, with the plunger removed, and guided by air bubble eruption. RESULTS: Vision was promptly recovered following drainage of the orbital emphysema. CONCLUSION: The development of orbital emphysema after an orbital fracture is a consequence of a forceful expiratory effort raising intranasal pressure. It must be drained, as described, in cases of vascular compression.

Anti-Inflammatory Agents↗
PubMed2006

[Our approach in the treatment of exposed hydroxyapatite orbital implant].

PURPOSE: To present our approach in the treatment of exposed hydroxyapatite (HA) orbital implant. PATIENTS AND METHODS: Seven patients with HA orbital implant exposure presented for treatment, all primary implants, postevisceration. All patients were operated by the same surgeon. The size of implant was based on preoperative axial length measurement (ax-2 mm, subtract 1 mm for evisceration and hyperops) except for two patients with buphthalmus where 20 mm implant was used. HA implant was wraped in sclera papillar area turned anteriorly. It was pushed as far as possible into the orbit but unfortunately without using plastic drape or malleable retractors. Extraocular muscles were sutured in their anatomic position. Exposure occurred at 5-7 years of implantation. Six patients wore glass orbital prostheses, and one silicone orbital prosthesis. The size of dehiscence of conjunctiva and Tenon's capsule varied from 5 to 15 mm. A woman with 15 mm exposure presented first with 6 mm exposure. However, she declined immediate surgery and continued to wear glass epiprosthesis. She returned a year later when she could not wear epiprosthesis anymore, and the size of the defect increased to 15 mm. Two-step procedure was performed in local anesthesia. Conjunctival edges were freshened, undermined and the anterior surface of the HA implant was shaved to the depth of at least 2 mm. Tarsoconjunctival flap was tailored from the central part of the lid. Care was taken that at least four millimeters of the marginal height of the tarsal plate were kept intact to avoid lid notching. Conjunctiva was undermined superiorly to include conjunctiva and Müllers muscle into the flap. No donor sclera was available. Raw surface of the flap faced the defect. Interrupted 6-0 Vicryl sutures were put on the flap, 360 degrees around. In two patients with exposure measuring 9 and 11 mm tarsoconjunctival pedicle flap from lax lower lid was incorporated. Upper and lower lid tarsoconjunctival flaps were sutured together. Central temporary tarsorrhaphy was performed so that postoperative local antibiotic (Tobrex) could be applied through the lateral third of the palpebral opening. At four weeks, flap was divided under local anesthesia. In two patients with lower lid flaps, horizontal shortening of the lower lid for the size of the flap was perfomed. In one patient with a 15-mm defect, third surgery was required. A crescent defect starting from superonasally to inferotemporally, horizontal diameter of 4 mm, was covered with conjunctival pedicle flap, base located inferotemporally. The harvest area was covered with oral mucosa membrane graft. Follow-up varied from 2 months to 5 years. RESULTS: Two patients experienced thick mucous discharge starting two weeks after the first step of the surgery. Bacteria and fungi were not isolated. After a 10-day course of systemic antibiotics the discharge subsided and the flap had taken nicely. Two patients had granuloma prior to pedicle division, which was removed and the area healed. There was no evidence of further exposure in any patient and all were able to wear orbital epiprosthesis. CONCLUSION: Tarsoconjunctival pedicle flap is a safe procedure to cover the exposure of hydroxyapatite orbital implant. A limited size of the flap and the need of temporary tarsorrhaphy are the only disadvantages of the procedure.

Aged↗
PubMed2006

[Reconstruction of orbital floor defect with polylacticglycolide acid/recombinant human bone morphogenetic protein 2 compound implanted material in sheep].

OBJECTIVE: To study the effect and safety of polylacticglycolide acid copolymer (PLGA) and recombinant human bone morphogenetic protein 2 (rhBMP-2) as implanted biomaterials for reconstruction orbital floor defects in sheep and find the relationship between implant materials degradation and orbital floor defects restoration. METHODS: Nine sheep (eighteen eyes) with orbital floor defect were divided into three groups randomly. Group A was the control without treatment. Group B was treated with PLGA and group C was received PLGA/rhBMP-2. Cosmetic appearances and complications were observed after surgery. CT scan, 3D reconstruction, defect area measurement and histological examination were performed on a week, three months and six months after operation. RESULTS: No complication was observed. The CT examinations showed that orbital floor defect in group C was almost disappeared by six months, however in group A and group B only partially orbital floor defect was repaired. Histological examinations showed that all materials were absorbed on six months. The orbit defects in group A were replaced by fiber tissue. The defect areas in group B were consisted of bone tissue in the peripheral and fiber tissue in the center. In group C the reconstructed areas were replaced by bone tissue, loose connective tissue and mucosal epithelia layers. CONCLUSION: The thick of 0.5 mm PLGA/rhBMP-2 sheet is a good substitute material of bone graft and may be used for orbital fracture defect reconstruction in clinic in the future.

Absorbable Implants↗
PubMed1987

Complex orbital trauma: the role of rigid fixation and primary bone grafting.

High-velocity trauma to the orbit is characterized by complete disruption of the orbital rim and comminution of the walls of the orbital cavity. The incidence of associated injury to the intraorbital contents, and to contiguous facial skeletal structures, is significant. Failure to recognize and repair the skeletal injuries results in progressive contracture of the overlying soft tissues, collapse of the bony framework of the orbit, and atrophy of incarcerated intraorbital contents. Immediate orbital reconstruction aims to restore and maintain the normal anatomy of the craniofacial skeleton. The introduction of computed tomography (CT) and craniofacial surgical techniques facilitates comprehensive evaluation of orbital fractures. Further adaptation of the principles and techniques of rigid internal skeletal fixation and primary bone grafting permits a stable, three-dimensional, anatomic reconstruction of virtually any traumatic orbital deformity.

Bone Plates↗