DOI QR코드

DOI QR Code

Correction of post-traumatic enophthalmos with anatomical absorbable implant and iliac bone graft

  • Choi, Ji Seon (Department of Plastic and Reconstructive Surgery, St. Vincent Hospital, College of Medicine, The Catholic University of Korea) ;
  • Oh, Se Young (Department of Plastic and Reconstructive Surgery, St. Vincent Hospital, College of Medicine, The Catholic University of Korea) ;
  • Shim, Hyung-Sup (Department of Plastic and Reconstructive Surgery, St. Vincent Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2019.09.05
  • Accepted : 2019.10.17
  • Published : 2019.12.20

Abstract

Background: Trauma is one of the most common causes of enophthalmos, and post-traumatic enophthalmos primarily results from an increased volume of the bony orbit. We achieved good long-term results by simultaneously using an anatomical absorbable implant and iliac bone graft to correct post-traumatic enophthalmos. Methods: From January 2012 to December 2016, we performed operations on seven patients with post-traumatic enophthalmos. In all seven cases, reduction surgery for the initial trauma was performed at our hospital. Hertel exophthalmometry, clinical photography, three-dimensional computed tomography (3D-CT), and orbital volume measurements using software to calculate the specific volume captured on 3D-CT (ITK-SNAP, Insight Toolkit-SNAP) were performed preoperatively and postoperatively. Results: Patients were evaluated based on exophthalmometry, clinical photographs, 3D-CT, and orbital volume measured by the ITK-SNAP program at 5 days and 1 year postoperatively, and all factors improved significantly compared with the preoperative baseline. Complications such as hematoma or extraocular muscle limitation were absent, and the corrected orbital volume was well maintained at the 1-year follow-up visit. Conclusion: We present a method to correct enophthalmos by reconstructing the orbital wall using an anatomical absorbable implant and a simultaneous autologous iliac bone graft. All cases showed satisfactory results for enophthalmos correction. We suggest this method as a good option for the correction of post-traumatic enophthalmos.

Keywords

References

  1. McRae M, Augustine HFM, Budning A, Antonyshyn O. Functional outcomes of late posttraumatic enophthalmos correction. Plast Reconstr Surg 2018;142:169e-178e. https://doi.org/10.1097/PRS.0000000000004600
  2. Clauser L, Galie M, Pagliaro F, Tieghi R. Posttraumatic enophthalmos: etiology, principles of reconstruction, and correction. J Craniofac Surg 2008;19:351-9. https://doi.org/10.1097/SCS.0b013e3180534361
  3. Hunter PD, Baker SS. The treatment of enophthalmos by orbital injection of fat autograft. Arch Otolaryngol Head Neck Surg 1994;120:835-9. https://doi.org/10.1001/archotol.1994.01880320037009
  4. Metzler P, Ezaldein HH, Pfaff MJ, Parsaei Y, Steinbacher DM. Correction of severe enophthalmos by simultaneous fat grafting and anatomic orbital reconstruction. J Craniofac Surg 2014; 25:1829-32. https://doi.org/10.1097/SCS.0000000000001057
  5. Pedemonte Trewhela C, Diaz Reiher M, Munoz Zavala T, Gonzalez Mora LE, Vargas Farren I. Correction of delayed traumatic enophthalmos using customized orbital implants. J Oral Maxillofac Surg 2018;76:1937-45. https://doi.org/10.1016/j.joms.2018.03.015
  6. Kim TH, Park IH, Hong SH, Eun SC. Sliced costochondral chip grafts in posttraumatic enophthalmos correction. J Craniofac Surg 2017;28:418-21. https://doi.org/10.1097/SCS.0000000000003331
  7. Lee JW. Treatment of enophthalmos using corrective osteotomy with concomitant cartilage-graft implantation. J Plast Reconstr Aesthet Surg 2010;63:42-53. https://doi.org/10.1016/j.bjps.2008.08.060
  8. Hwang K, Kim DH. Comparison of the supporting strength of a poly-L-lactic acid sheet and porous polyethylene (Medpor) for the reconstruction of orbital floor fractures. J Craniofac Surg 2010;21:847-53. https://doi.org/10.1097/SCS.0b013e3181d7f2ff
  9. Baek WI, Kim HK, Kim WS, Bae TH. Comparison of absorbable mesh plate versus titanium-dynamic mesh plate in reconstruction of blow-out fracture: an analysis of long-term outcomes. Arch Plast Surg 2014;41:355-61. https://doi.org/10.5999/aps.2014.41.4.355
  10. Zhang Y, He Y, Zhang ZY, An JG. Evaluation of the application of computer-aided shape-adapted fabricated titanium mesh for mirroring-reconstructing orbital walls in cases of late posttraumatic enophthalmos. J Oral Maxillofac Surg 2010;68:2070-5. https://doi.org/10.1016/j.joms.2009.08.029
  11. Kwon H, Kim HJ, Seo BF, Jeong YJ, Jung SN, Shim HS. The role of resorbable plate and artificial bone substitute in reconstruction of large orbital floor defect. Biomed Res Int 2016;2016:1358312. https://doi.org/10.1155/2016/1358312