Orbital floor reconstruction with ethyl-2-cyanoacrylate

Orbital floor fractures are common in maxillofacial trauma. Traditional reconstruction methods include autologous grafts, alloplastic materials, or bone from donor sites like the iliac crest. Each approach has limitations, such as donor site morbidity or material integration issues. Prior research has shown that autologous bone grafts offer better biocompatibility but require sufficient bone fragments. This gap motivated the development of a novel technique using ethyl-2-cyanoacrylate to stabilize orbital bone fragments. Existing studies suggest that cyanoacrylates can bond bone effectively, but their use in orbital reconstruction is less documented. This paper introduces a method that avoids donor site harvesting while maintaining structural integrity. The study addresses the need for a reliable, minimally invasive alternative to traditional grafting. By using autologous bone fragments and a cyanoacrylate adhesive, the authors aim to improve surgical outcomes and reduce complications.

The study aimed to evaluate a novel orbital floor reconstruction method using ethyl-2-cyanoacrylate to stabilize autologous bone fragments. The authors sought to determine if this technique could reduce donor site morbidity while maintaining functional and aesthetic outcomes. They focused on patients with fresh orbital floor fractures where sufficient bone fragments were available for reconstruction. The goal was to assess the safety and efficacy of this approach compared to traditional grafting methods. The study also aimed to identify specific indications for which this method is most suitable. By avoiding iliac crest grafts, the authors hoped to minimize postoperative complications like infection or foreign body reactions. The primary outcome was the correction of diplopia and prevention of enophthalmos. The study's findings could offer a new standard for orbital reconstruction in selected cases.

The study involved 96 patients with fresh orbital floor fractures. For 31 patients, the authors used autologous bone fragments fixed with ethyl-2-cyanoacrylate. Soft tissues were freed and repositioned intraorbitally under microscopic guidance. Bone fragments were gathered and adhered to a bone board using the adhesive. The reconstructed bone was then returned to the fracture site. In 48 patients, simple reduction was performed without grafting. Twelve patients received iliac crest bone grafts, and five were treated with alloplastic materials. The procedure was repeated in one patient who experienced bone collapse into the maxillary sinus. Postoperative outcomes were assessed for diplopia correction, enophthalmos, infection, and foreign body reactions. The method's success was evaluated based on the number of cases where grafting was avoided and complications were minimized. The study focused on patients with sufficient bone fragments to allow this technique.

The method was used in 31 patients (32.3% of the total cohort). Diplopia was corrected in 26 of these patients. In 48 patients, simple reduction was performed without grafting. Twelve patients received iliac crest grafts, and five were treated with alloplastic materials. The reconstructed bone collapsed into the maxillary sinus in one patient who underwent reoperation with iliac grafting. Four patients did not show preoperative diplopia. No cases of enophthalmos, foreign body reaction, or infection were reported postoperatively. The authors successfully avoided donor site harvesting in 30 of 48 cases requiring grafting (62.5%). The method's indications include the availability of sufficient bone fragments that can be stabilized without collapsing into the maxillary sinus. The study suggests that ethyl-2-cyanoacrylate can effectively bond bone fragments for orbital reconstruction. These results support the method as a safe and useful alternative to traditional grafting techniques.

The authors conclude that orbital floor reconstruction using ethyl-2-cyanoacrylate is a safe and useful method in selected cases. The technique allows for autologous bone reconstruction without donor site harvesting in 62.5% of cases requiring grafting. The study shows that diplopia was corrected in 26 of 31 patients treated with this method. No postoperative complications like enophthalmos or infection were observed. The method's success depends on the availability of sufficient bone fragments that can be stabilized without collapsing into the maxillary sinus. The authors propose that this approach offers advantages over traditional grafting methods by reducing donor site morbidity. The study's findings suggest that ethyl-2-cyanoacrylate can effectively bond bone fragments for orbital reconstruction. These results support the use of this method as a viable alternative in appropriate clinical scenarios.