Modified individualized titanium mesh in orbital floor reconstruction for preventing exposure

Area of Science:

• Oral and Maxillofacial Surgery
• Reconstructive Surgery
• Biomaterials Engineering

Background:

• Orbital floor and maxillary defects often require reconstruction with titanium mesh.
• Traditional fixation methods can sometimes lead to complications like mesh exposure.
• Improved fixation techniques are crucial for successful reconstructive outcomes.

Purpose of the Study:

• To introduce a novel medial fixation method for titanium mesh using an angled screwdriver.
• To compare the outcomes of this modified technique with traditional methods in orbital floor reconstruction.

Main Methods:

• Retrospective review of 23 patients undergoing maxillectomy and orbital floor reconstruction with titanium mesh.
• Group A (8 patients) received modified fixation with an angled screwdriver; Group B (15 patients) received traditional fixation.
• Assessment included mesh contact area, deformation, fracture, exposure, ophthalmic function, and aesthetic restoration.

Main Results:

• The modified technique (Group A) had a significantly smaller mesh contact area with the buccal flap compared to the traditional method (Group B).
• Two cases of titanium mesh exposure occurred in the traditional group (Group B).
• No significant differences were observed in facial symmetry or ophthalmic function between the groups.

Conclusions:

• A novel medial fixation technique using an angled screwdriver for titanium mesh in orbital and maxillary reconstruction is presented.
• This method shows potential in preventing postoperative titanium mesh exposure.
• The modified technique offers comparable aesthetic results to traditional approaches.