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Secondary reconstruction of posttraumatic orbital deformities
1Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia 19104.
Annals of Plastic Surgery
|December 1, 1990
Summary
Secondary orbital reconstruction aims to repair orbital injuries. While it significantly improves appearance, it often requires multiple surgeries and may not fully restore the pre-injury look compared to acute reconstruction.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Reconstructive Surgery
Background:
- Orbital injuries can cause significant aesthetic and functional deficits.
- Secondary reconstruction addresses persistent deformities after initial trauma or surgery.
Purpose of the Study:
- To present a 15-year experience with secondary orbital reconstruction techniques.
- To analyze the outcomes and limitations of secondary orbital repair.
Main Methods:
- Retrospective analysis of 78 patients undergoing secondary orbital reconstruction.
- Detailed description of the four-step surgical technique: soft tissue dissection, skeletal reconstruction (bone grafting, osteoplasty), canthopexy, and soft tissue refinement.
Main Results:
- Reconstruction averaged at least two operations per patient.
- Complications included three infections; no mortalities or bleeding reoperations occurred.
- Thirty patients needed further surgery due to technical issues, graft unpredictability, or scarring.
Conclusions:
- Secondary orbital reconstruction offers significant improvement for skeletal deformities.
- Soft tissue distortions and contraction remain challenging, limiting aesthetic restoration.
- Outcomes typically fall short of primary acute reconstruction results.