Safety of Silastic Sheet for Orbital Wall Reconstruction

Background Many implants are being used for the reconstruction of orbital wall fractures. The effect of the choice of implant for the reconstruction of an orbital wall fracture on the surgical outcome is under debate. The purpose of this article is to compare the outcomes of orbital wall reconstruction of small orbital wall fractures on the basis of the implants used.

Methods The authors conducted a retrospective study using electronic databases. Between March 2001 and December 2012, 461 patients with orbital wall fractures were included in this study. Among them, 431 patients in whom the fracture size was less than 300 mm² were analyzed. The fracture size was calculated using computed tomography scans of the orbit in the sagittal and coronal images. Cases in which the fracture size was less than 300 mm² were included in this study.

Results One hundred and twenty-nine patients were treated with silastic sheets; 238 patients were treated with titanium meshes; and absorbable meshes were used in the case of 64 patients. Overall, 13 patients required revision, and the revision rate was 3.0%. The revision rate of the silastic sheet group was 5.4%. In the multivariable analysis, the revision rate of the group reconstructed with silastic sheets was highly statistically significant (P=0.043, odds ratio=3.65). However, other factors such as age, sex, fracture type, and fracture size were not significant.

Conclusions Reconstruction of orbital wall fractures with silastic sheets may cause more complications than that with other materials such as titanium meshes and absorbable meshes.

Keywords

Orbital fracture - Silicone

This article was presented at the Annual Meeting of Korean Society of Plastic and Reconstructive Surgeons on November 1, 2013 in Seoul, Korea.

Publikationsverlauf

Eingereicht: 05. Februar 2014

Angenommen: 19. Mai 2014

Artikel online veröffentlicht:
05. Mai 2022

• References

• 1 Cole P, Boyd V, Banerji S. et al. Comprehensive management of orbital fractures. Plast Reconstr Surg 2007; 120: 57S-63S
• 2 Brucoli M, Arcuri F, Cavenaghi R. et al. Analysis of complications after surgical repair of orbital fractures. J Craniofac Surg 2011; 22: 1387-1390
• 3 Park MS, Kim YJ, Kim H. et al. Prevalence of Diplopia and Extraocular Movement Limitation according to the Location of Isolated Pure Blowout Fractures. Arch Plast Surg 2012; 39: 204-208
• 4 Bratton EM, Durairaj VD. Orbital implants for fracture repair. Curr Opin Ophthalmol 2011; 22: 400-406
• 5 Ploder O, Klug C, Voracek M. et al. A computer-based method for calculation of orbital floor fractures from coronal computed tomography scans. J Oral Maxillofac Surg 2001; 59: 1437-1442
• 6 Jaquiery C, Aeppli C, Cornelius P. et al. Reconstruction of orbital wall defects: critical review of 72 patients. Int J Oral Maxillofac Surg 2007; 36: 193-199
• 7 Morrison AD, Sanderson RC, Moos KF. The use of silastic as an orbital implant for reconstruction of orbital wall defects: review of 311 cases treated over 20 years. J Oral Maxillofac Surg 1995; 53: 412-417
• 8 Schmidt BL, Lee C, Young DM. et al. Intraorbital squamous epithelial cyst: an unusual complication of Silastic implantation. J Craniofac Surg 1998; 9: 452-455
• 9 Lee HB, Nunery WR. Orbital adherence syndrome secondary to titanium implant material. Ophthal Plast Reconstr Surg 2009; 25: 33-36
• 10 Yun HK, Yi S, Joh SP. et al. Complications after open reduction of blow-out fracture using silicone sheet. J Korean Cleft Palate-Craniofac Assoc 2001; 2: 72-76
• 11 Prowse SJ, Hold PM, Gilmour RF. et al. Orbital floor reconstruction: a case for silicone. A 12 year experience. J Plast Reconstr Aesthet Surg 2010; 63: 1105-1109