Preformed vs intraoperative bending of titanium mesh for orbital reconstruction

E Bradley Strong, Scott Fuller, David F. Wiley, Janina Zumbansen, M. D. Wilson, Marc C. Metzger

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Objective. The most accurate orbital reconstructions result from an anatomic repair of the premorbid orbital architecture. Many different techniques and materials have been used; unfortunately, there is currently no optimal method. This study compares the use of preformed vs intraoperative bending of titanium mesh for orbital reconstruction in 2-wall orbital fractures. Study Design. Cadaver-based study. Setting. University hospital. Subjects and Methods. Preinjury computed tomography scans were obtained in 15 cadaveric heads (30 orbits). Stereolithographic (STL) models were fabricated for 5 of the specimens (10 orbits). Two wall fractures (lamina papyracea and floor) were then generated in all orbits. Surgical reconstruction was performed in all orbits using 1 of 3 techniques (10 orbits each): (1) patient-specific implant molded from the preinjury STL model, (2) titanium mesh sheet bent freehand, and (3) preformed titanium mesh. Each technique was evaluated for orbital volume correction, contour accuracy, ease of use, and cost. Results. No difference in volume restoration was found between the 3 techniques. Patient-specific implants had the greatest contour accuracy, poor ease of use, and highest cost. Freehand bending implants had the poorest contour accuracy, acceptable ease of use, and lowest cost. Preformed mesh implants had intermediate contour accuracy, excellent ease of use, and low cost. Conclusion. All 3 techniques provide equivalent orbital volume correction. However, preformed mesh implants have many advantages based on contour accuracy, ease of use, and relative cost.

Original languageEnglish (US)
Pages (from-to)60-66
Number of pages7
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume149
Issue number1
DOIs
StatePublished - Jul 2013

Keywords

  • Computer software
  • Facial fracture
  • Facial reconstruction
  • Facial trauma
  • Fracture
  • Orbit
  • Orbital reconstruction
  • Orbital trauma
  • Orbital volume
  • Trauma
  • Volume analysis

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

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