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Periorbital Reconstruction by “Periorbital Patch” Technique Using a Pericardium-Based Collagen Membrane and Titanium Mesh

Objective: Titanium mesh is a commonly used material for the reconstruction of orbital floor fractures. However, in some instances, a subsequent inflammatory reaction can occur that causes the adhesion of orbital tissue to the titanium mesh. The adhesion of the orbital soft tissue to the mesh causes...

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Autores principales: Tanaskovic, Nenad, Trajkovski, Branko, Perić Kačarević, Željka, Rider, Patrick M., Houshmand, Alireza, Xiong, Xin, Jung, Ole, Barbeck, Mike
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696015/
https://www.ncbi.nlm.nih.gov/pubmed/31344797
http://dx.doi.org/10.3390/ma12152343
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author Tanaskovic, Nenad
Trajkovski, Branko
Perić Kačarević, Željka
Rider, Patrick M.
Houshmand, Alireza
Xiong, Xin
Jung, Ole
Barbeck, Mike
author_facet Tanaskovic, Nenad
Trajkovski, Branko
Perić Kačarević, Željka
Rider, Patrick M.
Houshmand, Alireza
Xiong, Xin
Jung, Ole
Barbeck, Mike
author_sort Tanaskovic, Nenad
collection PubMed
description Objective: Titanium mesh is a commonly used material for the reconstruction of orbital floor fractures. However, in some instances, a subsequent inflammatory reaction can occur that causes the adhesion of orbital tissue to the titanium mesh. The adhesion of the orbital soft tissue to the mesh causes diplopia, lid rigidity and extraocular movements restriction. This study was performed to determine if the placement of a collagen membrane over a titanium mesh can prevent the adhesion of orbital soft tissue for an improved clinical outcome. Clinical considerations: A case study was performed investigating 106 patients undergoing a periorbital restoration. Seventy-two patients received a titanium mesh without a barrier membrane, 12 patients received a barrier membrane composed of autologous auricular cartilage to provide a barrier function and 22 patients received a pericardium collagen membrane and titanium mesh. Conclusions: Titanium has been shown to generate an intense inflammatory reaction in host tissues, which can cause fibrosis to adjacent structures. Fibrosis is an essential factor in the repair of fracture sites, however this can lead to adverse effects in the orbital socket. Fibrosis can cause cicatrization and lower eyelid retraction when induced along the lower orbital rim. An improved outcome can be achieved by using a barrier between the titanium mesh and the soft tissue, such as autogenous auricular cartilage, however, only patients treated with a resorbable collagen membrane to act as a soft tissue barricade during site regeneration, prevented the fibrosis reaction and related problems from occurring.
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spelling pubmed-66960152019-09-05 Periorbital Reconstruction by “Periorbital Patch” Technique Using a Pericardium-Based Collagen Membrane and Titanium Mesh Tanaskovic, Nenad Trajkovski, Branko Perić Kačarević, Željka Rider, Patrick M. Houshmand, Alireza Xiong, Xin Jung, Ole Barbeck, Mike Materials (Basel) Article Objective: Titanium mesh is a commonly used material for the reconstruction of orbital floor fractures. However, in some instances, a subsequent inflammatory reaction can occur that causes the adhesion of orbital tissue to the titanium mesh. The adhesion of the orbital soft tissue to the mesh causes diplopia, lid rigidity and extraocular movements restriction. This study was performed to determine if the placement of a collagen membrane over a titanium mesh can prevent the adhesion of orbital soft tissue for an improved clinical outcome. Clinical considerations: A case study was performed investigating 106 patients undergoing a periorbital restoration. Seventy-two patients received a titanium mesh without a barrier membrane, 12 patients received a barrier membrane composed of autologous auricular cartilage to provide a barrier function and 22 patients received a pericardium collagen membrane and titanium mesh. Conclusions: Titanium has been shown to generate an intense inflammatory reaction in host tissues, which can cause fibrosis to adjacent structures. Fibrosis is an essential factor in the repair of fracture sites, however this can lead to adverse effects in the orbital socket. Fibrosis can cause cicatrization and lower eyelid retraction when induced along the lower orbital rim. An improved outcome can be achieved by using a barrier between the titanium mesh and the soft tissue, such as autogenous auricular cartilage, however, only patients treated with a resorbable collagen membrane to act as a soft tissue barricade during site regeneration, prevented the fibrosis reaction and related problems from occurring. MDPI 2019-07-24 /pmc/articles/PMC6696015/ /pubmed/31344797 http://dx.doi.org/10.3390/ma12152343 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tanaskovic, Nenad
Trajkovski, Branko
Perić Kačarević, Željka
Rider, Patrick M.
Houshmand, Alireza
Xiong, Xin
Jung, Ole
Barbeck, Mike
Periorbital Reconstruction by “Periorbital Patch” Technique Using a Pericardium-Based Collagen Membrane and Titanium Mesh
title Periorbital Reconstruction by “Periorbital Patch” Technique Using a Pericardium-Based Collagen Membrane and Titanium Mesh
title_full Periorbital Reconstruction by “Periorbital Patch” Technique Using a Pericardium-Based Collagen Membrane and Titanium Mesh
title_fullStr Periorbital Reconstruction by “Periorbital Patch” Technique Using a Pericardium-Based Collagen Membrane and Titanium Mesh
title_full_unstemmed Periorbital Reconstruction by “Periorbital Patch” Technique Using a Pericardium-Based Collagen Membrane and Titanium Mesh
title_short Periorbital Reconstruction by “Periorbital Patch” Technique Using a Pericardium-Based Collagen Membrane and Titanium Mesh
title_sort periorbital reconstruction by “periorbital patch” technique using a pericardium-based collagen membrane and titanium mesh
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696015/
https://www.ncbi.nlm.nih.gov/pubmed/31344797
http://dx.doi.org/10.3390/ma12152343
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