[Reconstruction of isolated orbital floor fractures with a prefabricated titanium mesh]

Concerning safety and efficiency in surgery of isolated orbital floor fractures, several treatment modalities are being discussed. It is a matter of recent interest that prefabricated titanium meshes provide significant advantages. The purpose of this study was to review the usability of the MatrixORBITAL® plate.

In a prospective study we evaluated 10 patients (June 2011 to November 2013) with an isolated orbital floor fracture. All patients in the study group had undergone reconstruction with the MatrixORBITAL® plate. For purposes of analysis were recorded: age, gender, fracture category according to Jaquiéry et al. (2007), duration of surgery, complications, globe motility (Harms wall), exophthalmometry, function of the infraorbital nerve, evaluation of facial symmetry and aesthetic as well as personal contentment of the patient. A reference group received a PDS® sheet, an antral balloon or other materials.

In the study group (2 women and 8 men aged between 26 and 83 years) all cases presented a large disruption of the orbital floor (> 2 cm2 bony defect; category II-III). Volume changes were universally associated with diplopia, but only in two cases with an entrapment of the inferior rectus muscle. The mean duration of the operation was 110 minutes (minimum 50, maximum 135 minutes). Postoperatively diplopia was decreasing in all cases. None of the patients had a significant impairment of visus and no reoperation was necessary. The analysis of functional outcomes between the groups mesh, PDS sheet and antral balloon revealed no significant differences.

Based on this experience and due to good intraoperative handling, the authors recommend the prefabricated titanium plate in the treatment of isolated orbital wall fractures or in combination with the medial wall despite the material costs.