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Related Experiment Video

Updated: Feb 16, 2026

Three-Dimensional Reconstruction of Orbital Fractures
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Three-Dimensional Reconstruction of Orbital Fractures

Published on: May 16, 2025

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Deciding when and when not to reconstruct the orbit: How I do it.

Jihad Abdelgadir1, Jeffrey Nadel1, Tanner J Zachem2

  • 1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT, 84132, USA.

Acta Neurochirurgica
|February 14, 2026
PubMed
Summary

Orbital reconstruction after transcranial surgery is crucial for preventing pulsatile enophthalmos, especially for lesions without significant bony changes. A staged approach can effectively manage delayed complications.

Keywords:
Cranio-orbital junctionOrbit reconstructionTumor

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Area of Science:

  • Neurosurgery and Orbital Surgery
  • Oncology and Skull Base Surgery

Background:

  • Combined transcranial and orbital surgery presents challenges in orbital reconstruction decisions.
  • Upfront orbital reconstruction is vital for lesions without bony remodeling or tissue stiffening.
  • Delayed pulsatile enophthalmos can occur from orbital compression by intracranial lesions.

Purpose of the Study:

  • To detail a staged orbital reconstruction technique for managing delayed pulsatile enophthalmos.
  • To discuss indications for orbital reconstruction following transcranial surgery for skull base tumors.

Main Methods:

  • Case presentation of a 50-year-old man with pulsatile enophthalmos post-planum sphenoidale meningioma resection.
  • Description of a staged orbital reconstruction procedure.
  • Review of indications for orbital reconstruction in similar cases.

Main Results:

  • The staged orbital reconstruction technique was successfully applied to treat delayed pulsatile enophthalmos.
  • Orbital reconstruction is indicated for lesions compressing the orbit, even if not directly involving orbital tissues.
  • A delayed, staged approach can effectively manage specific postoperative orbital complications.

Conclusions:

  • Orbital reconstruction is critical to prevent delayed pulsatile enophthalmos in specific cases after transcranial surgery.
  • A staged approach offers a viable solution for managing delayed orbital complications, including pulsatile enophthalmos.
  • Careful consideration of lesion characteristics and potential for orbital compression guides reconstruction decisions.