Skip to main content
Erschienen in: European Journal of Plastic Surgery 2/2020

02.01.2020 | Review

Alloplastic reconstruction of orbital floor fractures: a systematic review and pooled outcomes analysis

verfasst von: Jeremie D. Oliver, Elias S. Saba, Nikita Gupta, Tina M. Hendricks, Davinder J. Singh

Erschienen in: European Journal of Plastic Surgery | Ausgabe 2/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

Orbital floor defects from traumatic injuries can be successfully repaired surgically utilizing alloplastic implants. The objective of this study was to conduct a comprehensive systematic review of alloplastic implant materials utilized in the repair of orbital floor fractures stratified by material type, indication for surgery, and outcomes in all reported cases to date.

Methods

A comprehensive systematic review of published literature on alloplastic periorbital implant studies was conducted utilizing Medline/PubMed database without timeframe limitations. Articles were reviewed in full by multiple authors and outcomes data were collected.

Results

A total of 11 studies (n = 585 patients) were identified to meet the inclusion criteria. Overall, 25 total surgical complications (4.3%) were noted, including infection, inflammation, graft migration or explantation, and hematoma. Overall, porous polyethylene (PPE) implants were associated with the highest rate of infection (2.0%) compared with all other implant types analyzed. Poly-l-lactic acid (PLLA) implants were associated with the highest rate of graft explantation (5.9%). Explantation was required in a total 0.6% of all implants (n = 3).

Conclusions

Alloplastic implants are a reliable means of reconstructing the orbital floor following trauma. It is imperative for surgeons to understand the relative risks for each type of implant to develop postoperative complications in order to optimize outcomes.
Level of evidence: Level III, therapeutic study
Literatur
1.
Zurück zum Zitat Smith B, Regan WF (1957) Blow-out fracture of the orbit*: mechanism and correction of internal orbital fracture. Am J Ophthalmol 44(6):733–739CrossRef Smith B, Regan WF (1957) Blow-out fracture of the orbit*: mechanism and correction of internal orbital fracture. Am J Ophthalmol 44(6):733–739CrossRef
2.
Zurück zum Zitat Fujino T, Makino K (1980) Entrapment mechanism and ocular injury in orbital blowout fracture. Plast Reconstr Surg 65(5):571–576CrossRef Fujino T, Makino K (1980) Entrapment mechanism and ocular injury in orbital blowout fracture. Plast Reconstr Surg 65(5):571–576CrossRef
3.
Zurück zum Zitat Burnstine MA (2002) Clinical recommendations for repair of isolated orbital floor fractures: an evidence-based analysis1. Ophthalmology. 109(7):1207–1210CrossRef Burnstine MA (2002) Clinical recommendations for repair of isolated orbital floor fractures: an evidence-based analysis1. Ophthalmology. 109(7):1207–1210CrossRef
4.
Zurück zum Zitat Cole P, Boyd V, Banerji S, Hollier LH Jr (2007) Comprehensive management of orbital fractures. Plast Reconstr Surg 120(7):57S–63SCrossRef Cole P, Boyd V, Banerji S, Hollier LH Jr (2007) Comprehensive management of orbital fractures. Plast Reconstr Surg 120(7):57S–63SCrossRef
5.
Zurück zum Zitat Mok D, Lessard L, Cordoba C, Harris PG, Nikolis A (2004) A review of materials currently used in orbital floor reconstruction. Can J Plastic Surg 12(3):134–140CrossRef Mok D, Lessard L, Cordoba C, Harris PG, Nikolis A (2004) A review of materials currently used in orbital floor reconstruction. Can J Plastic Surg 12(3):134–140CrossRef
6.
Zurück zum Zitat Chowdhury K, Krause GE (1998) Selection of materials for orbital floor reconstruction. Arch Otolaryngol Head Neck Surg 124(12):1398–1401CrossRef Chowdhury K, Krause GE (1998) Selection of materials for orbital floor reconstruction. Arch Otolaryngol Head Neck Surg 124(12):1398–1401CrossRef
7.
Zurück zum Zitat Iatrou I, Theologie-Lygidakis N, Angelopoulos A (2001) Use of membrane and bone grafts in the reconstruction of orbital fractures. Oral Surg Oral Me Oral Pathol Oral Radiol Endod 91(3):281–286CrossRef Iatrou I, Theologie-Lygidakis N, Angelopoulos A (2001) Use of membrane and bone grafts in the reconstruction of orbital fractures. Oral Surg Oral Me Oral Pathol Oral Radiol Endod 91(3):281–286CrossRef
8.
Zurück zum Zitat Johnson PE, Raftopoulos I (1999) In situ splitting of a rib graft for reconstruction of the orbital floor. Plast Reconstr Surg 103(6):1709–1711CrossRef Johnson PE, Raftopoulos I (1999) In situ splitting of a rib graft for reconstruction of the orbital floor. Plast Reconstr Surg 103(6):1709–1711CrossRef
9.
Zurück zum Zitat Mintz SM, Ettinger A, Schmakel T, Gleason MJ (1998) Contralateral coronoid process bone grafts for orbital floor reconstruction: an anatomic and clinical study. J Oral Maxillofac Surg 56(10):1140–1144CrossRef Mintz SM, Ettinger A, Schmakel T, Gleason MJ (1998) Contralateral coronoid process bone grafts for orbital floor reconstruction: an anatomic and clinical study. J Oral Maxillofac Surg 56(10):1140–1144CrossRef
10.
Zurück zum Zitat Kakibuchi M, Fukuda K, Yamada N, Matsuda K, Kawai K, Kubo T, Sakagami M (2003) A simple method of harvesting a thin iliac bone graft for reconstruction of the orbital wall. Plast Reconstr Surg 111(2):961–962CrossRef Kakibuchi M, Fukuda K, Yamada N, Matsuda K, Kawai K, Kubo T, Sakagami M (2003) A simple method of harvesting a thin iliac bone graft for reconstruction of the orbital wall. Plast Reconstr Surg 111(2):961–962CrossRef
11.
Zurück zum Zitat Skouteris CA, Sotereanos GC (1989) Donor site morbidity following harvesting of autogenous rib grafts. J Oral Maxillofac Surg 47(8):808–812CrossRef Skouteris CA, Sotereanos GC (1989) Donor site morbidity following harvesting of autogenous rib grafts. J Oral Maxillofac Surg 47(8):808–812CrossRef
12.
Zurück zum Zitat Haug RH, Nuveen E, Bredbenner T (1999) An evaluation of the support provided by common internal orbital reconstruction materials. J Oral Maxillofac Surg 57(5):564–570CrossRef Haug RH, Nuveen E, Bredbenner T (1999) An evaluation of the support provided by common internal orbital reconstruction materials. J Oral Maxillofac Surg 57(5):564–570CrossRef
13.
Zurück zum Zitat Laxenaire A, Levy J, Blanchard P, Lerondeau J, Tesnier F, Scheffer P (1997) Complications of silastic implants used in orbital repair. Rev Stomatol Chir Maxillofac 98:96–99PubMed Laxenaire A, Levy J, Blanchard P, Lerondeau J, Tesnier F, Scheffer P (1997) Complications of silastic implants used in orbital repair. Rev Stomatol Chir Maxillofac 98:96–99PubMed
14.
Zurück zum Zitat Klisovic DD, Katz SE, Lubow M (2002) The wayward implant: orbital silicone plate extrusion associated with squamous epithelial downgrowth and infection. Orbit. 21(2):149–154CrossRef Klisovic DD, Katz SE, Lubow M (2002) The wayward implant: orbital silicone plate extrusion associated with squamous epithelial downgrowth and infection. Orbit. 21(2):149–154CrossRef
15.
Zurück zum Zitat Dougherty WR, Wellisz T (1994) The natural history of alloplastic implants in orbital floor reconstruction: an animal model. J Craniofac Surg 5(1):26–32 discussion 33CrossRef Dougherty WR, Wellisz T (1994) The natural history of alloplastic implants in orbital floor reconstruction: an animal model. J Craniofac Surg 5(1):26–32 discussion 33CrossRef
16.
Zurück zum Zitat Cuzalina LA, Hlavacek MR (2009) Complications of facial implants. Oral Maxillofac Surg Clin North Am 21(1):91–104CrossRef Cuzalina LA, Hlavacek MR (2009) Complications of facial implants. Oral Maxillofac Surg Clin North Am 21(1):91–104CrossRef
17.
Zurück zum Zitat Baino F (2011) Biomaterials and implants for orbital floor repair. Acta Biomater 7(9):3248–3266CrossRef Baino F (2011) Biomaterials and implants for orbital floor repair. Acta Biomater 7(9):3248–3266CrossRef
18.
Zurück zum Zitat Kirby EJ, Turner JB, Davenport DL, Vasconez HC (2011) Orbital floor fractures: outcomes of reconstruction. Ann Plast Surg 66(5):508–512CrossRef Kirby EJ, Turner JB, Davenport DL, Vasconez HC (2011) Orbital floor fractures: outcomes of reconstruction. Ann Plast Surg 66(5):508–512CrossRef
19.
Zurück zum Zitat Ellis E III, Tan Y (2003) Assessment of internal orbital reconstructions for pure blowout fractures: cranial bone grafts versus titanium mesh. J Oral Maxillofac Surg 61(4):442–453CrossRef Ellis E III, Tan Y (2003) Assessment of internal orbital reconstructions for pure blowout fractures: cranial bone grafts versus titanium mesh. J Oral Maxillofac Surg 61(4):442–453CrossRef
20.
Zurück zum Zitat Kelly CP, Cohen AJ, Yavuzer R, Jackson IT (2005) Cranial bone grafting for orbital reconstruction: is it still the best? J Craniofac Surg 16(1):181–185CrossRef Kelly CP, Cohen AJ, Yavuzer R, Jackson IT (2005) Cranial bone grafting for orbital reconstruction: is it still the best? J Craniofac Surg 16(1):181–185CrossRef
21.
Zurück zum Zitat Gear AJ, Lokeh A, Aldridge JH, Migliori MR, Benjamin CI, Schubert W (2002) Safety of titanium mesh for orbital reconstruction. Ann Plast Surg 48(1):1–9CrossRef Gear AJ, Lokeh A, Aldridge JH, Migliori MR, Benjamin CI, Schubert W (2002) Safety of titanium mesh for orbital reconstruction. Ann Plast Surg 48(1):1–9CrossRef
22.
Zurück zum Zitat Yaremchuk MJ (2003) Facial skeletal reconstruction using porous polyethylene implants. Plast Reconstr Surg 111(6):1818–1827CrossRef Yaremchuk MJ (2003) Facial skeletal reconstruction using porous polyethylene implants. Plast Reconstr Surg 111(6):1818–1827CrossRef
23.
Zurück zum Zitat Rubin JP, Yaremchuk MJ (1997) Complications and toxicities of implantable biomaterials used in facial reconstructive and aesthetic surgery: a comprehensive review of the literature. Plast Reconstr Surg 100(5):1336–1353CrossRef Rubin JP, Yaremchuk MJ (1997) Complications and toxicities of implantable biomaterials used in facial reconstructive and aesthetic surgery: a comprehensive review of the literature. Plast Reconstr Surg 100(5):1336–1353CrossRef
24.
Zurück zum Zitat Garibaldi DC, Iliff NT, Grant MP, Merbs SL (2007) Use of porous polyethylene with embedded titanium in orbital reconstruction: a review of 106 patients. Ophthalmic Plast Reconstr Surg 23(6):439–444CrossRef Garibaldi DC, Iliff NT, Grant MP, Merbs SL (2007) Use of porous polyethylene with embedded titanium in orbital reconstruction: a review of 106 patients. Ophthalmic Plast Reconstr Surg 23(6):439–444CrossRef
25.
Zurück zum Zitat Rubin PA, Popham JK, Bilyk JR, Shore JW (1994) Comparison of fibrovascular ingrowth into hydroxyapatite and porous polyethylene orbital implants. Ophthalmic Plast Reconstr Surg 10(2):96–103CrossRef Rubin PA, Popham JK, Bilyk JR, Shore JW (1994) Comparison of fibrovascular ingrowth into hydroxyapatite and porous polyethylene orbital implants. Ophthalmic Plast Reconstr Surg 10(2):96–103CrossRef
26.
Zurück zum Zitat Mackenzie DJ, Arora B, Hansen J (1999) Orbital floor repair with titanium mesh screen. J Craniomaxillofac Trauma 5(3):9–16PubMed Mackenzie DJ, Arora B, Hansen J (1999) Orbital floor repair with titanium mesh screen. J Craniomaxillofac Trauma 5(3):9–16PubMed
27.
Zurück zum Zitat Nam SB, Bae YC, Moon JS, Kang YS (2006) Analysis of the postoperative outcome in 405 cases of orbital fracture using 2 synthetic orbital implants. Ann Plast Surg 56(3):263–267CrossRef Nam SB, Bae YC, Moon JS, Kang YS (2006) Analysis of the postoperative outcome in 405 cases of orbital fracture using 2 synthetic orbital implants. Ann Plast Surg 56(3):263–267CrossRef
28.
Zurück zum Zitat Elmazar H, Jackson IT, Degner D, Miyawaki T, Barakat K, Andrus L, Bradford M (2003) The efficacy of Gore-Tex vs. hydroxyapatite and bone graft in reconstruction of orbital floor defects. Eur J Plast Surg 25(7–8):362–368CrossRef Elmazar H, Jackson IT, Degner D, Miyawaki T, Barakat K, Andrus L, Bradford M (2003) The efficacy of Gore-Tex vs. hydroxyapatite and bone graft in reconstruction of orbital floor defects. Eur J Plast Surg 25(7–8):362–368CrossRef
29.
Zurück zum Zitat Park DJ, Garibaldi DC, Iliff NT, Grant MP, Merbs SL (2008) Smooth nylon foil (SupraFOIL) orbital implants in orbital fractures: a case series of 181 patients. Ophthalmic Plast Reconstr Surg 24(4):266–270CrossRef Park DJ, Garibaldi DC, Iliff NT, Grant MP, Merbs SL (2008) Smooth nylon foil (SupraFOIL) orbital implants in orbital fractures: a case series of 181 patients. Ophthalmic Plast Reconstr Surg 24(4):266–270CrossRef
30.
Zurück zum Zitat Cordewener FW, Bos RR, Rozema FR, Houtman WA (1996) Poly (L-lactide) implants for repair of human orbital floor defects: clinical and magnetic resonance imaging evaluation of long-term results. J Oral Maxillofac Surg 54(1):9–13CrossRef Cordewener FW, Bos RR, Rozema FR, Houtman WA (1996) Poly (L-lactide) implants for repair of human orbital floor defects: clinical and magnetic resonance imaging evaluation of long-term results. J Oral Maxillofac Surg 54(1):9–13CrossRef
31.
Zurück zum Zitat Balogh C, Lucas R, Kraft T, Breton P, Freidel M (2001) Lactic acid polymer implants in the repair of traumatic defects of the orbital floor. Rev Stomatol Chir Maxillofac 102(2):109–114PubMed Balogh C, Lucas R, Kraft T, Breton P, Freidel M (2001) Lactic acid polymer implants in the repair of traumatic defects of the orbital floor. Rev Stomatol Chir Maxillofac 102(2):109–114PubMed
32.
Zurück zum Zitat Bergsma JE, De Bruijn WC, Rozema FR, Bos RR, Boering G (1995) Late degradation tissue response to poly (L-lactide) bone plates and screws. Biomaterials. 16(1):25–31CrossRef Bergsma JE, De Bruijn WC, Rozema FR, Bos RR, Boering G (1995) Late degradation tissue response to poly (L-lactide) bone plates and screws. Biomaterials. 16(1):25–31CrossRef
33.
Zurück zum Zitat Jank S, Emshoff R, Schuchter B, Strobl H, Brandlmaier I, Norer B (2003) Orbital floor reconstruction with flexible Ethisorb patches: a retrospective long-term follow-up study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 95(1):16–22CrossRef Jank S, Emshoff R, Schuchter B, Strobl H, Brandlmaier I, Norer B (2003) Orbital floor reconstruction with flexible Ethisorb patches: a retrospective long-term follow-up study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 95(1):16–22CrossRef
34.
Zurück zum Zitat Büchel P, Rahal A, Seto I, Iizuka T (2005) Reconstruction of orbital floor fracture with polyglactin 910/polydioxanon patch (ethisorb): a retrospective study. J Oral Maxillofac Surg 63(5):646–650CrossRef Büchel P, Rahal A, Seto I, Iizuka T (2005) Reconstruction of orbital floor fracture with polyglactin 910/polydioxanon patch (ethisorb): a retrospective study. J Oral Maxillofac Surg 63(5):646–650CrossRef
Metadaten
Titel
Alloplastic reconstruction of orbital floor fractures: a systematic review and pooled outcomes analysis
verfasst von
Jeremie D. Oliver
Elias S. Saba
Nikita Gupta
Tina M. Hendricks
Davinder J. Singh
Publikationsdatum
02.01.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Plastic Surgery / Ausgabe 2/2020
Print ISSN: 0930-343X
Elektronische ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-019-01614-x

Weitere Artikel der Ausgabe 2/2020

European Journal of Plastic Surgery 2/2020 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.