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CC BY-NC-ND 4.0 · Indian J Plast Surg 2023; 56(01): 062-067
DOI: 10.1055/s-0043-1761597
Original Article

Outcome of Precontoured Titanium Mesh in the Reconstruction of Orbital Blowout Fractures

Amarnath Munoli
1   Department of Plastic and Reconstructive Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
,
Jinisha Bhanushali
1   Department of Plastic and Reconstructive Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
,
Mukund Jagannathan
1   Department of Plastic and Reconstructive Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
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Abstract

Background Orbital blowout fractures are peculiar injuries causing disruption of both ocular function and symmetry. We present our experience with the use of a precontoured titanium mesh in orbital blowout fractures.

Methods A retrospective study of patients undergoing correction of orbital blowout fractures with a precontoured titanium mesh was done at a tertiary care center in Mumbai. Data regarding demographics and pre- and postoperative clinical and radiological attributes were retrieved and compared.

Results A total of 21 patients (19 males and 2 females) underwent correction of blowout fractures with a precontoured titanium mesh. The follow-up period ranged from 6 to 10 months. Road traffic accident (76%) was the most common etiology. Twenty (95%) patients had impure blowout fractures and 1 (5%) patient had a pure blowout. The orbital floor was most commonly fractured (16 [76%]). Associated fractures of the zygomaticomaxillary complex were found in 71% of patients. All patients were operated on within 3 weeks of trauma. A comparison of the operated and uninjured sides on coronal views of computed tomography (CT) scan in nine patients by Photopea application revealed a correction of the increased cross-sectional area in all cases. Enophthalmos was completely corrected in 94% patients, while 92% patients had complete correction of diplopia. One patient with a comminuted zygomatic fracture had persistent diplopia and mild enophthalmos. Infraorbital paresthesia persisted in 58% patients at 6 months of follow-up. No significant postoperative complications were noted.

Conclusion The precontoured titanium mesh restores orbital wall anatomy and is safe, quick, fairly easy, and reproducible with a shorter learning curve. With proper patient selection and execution, prefabricated titanium mesh can serve as an excellent reconstructive option in blowout fractures of the orbit.

Key-Words

blowout fracture - titanium mesh - precontoured titanium mesh - enophthalmos - orbital floor


Publication History

Article published online:
07 February 2023

© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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