Cargando…
Patient specific implants in orbital reconstruction: A pilot study()
PURPOSE: Successful repair of the orbital skeleton restores function and cosmesis by normalizing globe position and allowing full motility of the extraocular muscles. Routine repairs are successful with standard implants. However, defects that are irregular or cause volume deficiency can be challeng...
Autores principales: | , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8554165/ https://www.ncbi.nlm.nih.gov/pubmed/34746511 http://dx.doi.org/10.1016/j.ajoc.2021.101222 |
_version_ | 1784591735847911424 |
---|---|
author | Habib, Larissa A. Yoon, Michael K. |
author_facet | Habib, Larissa A. Yoon, Michael K. |
author_sort | Habib, Larissa A. |
collection | PubMed |
description | PURPOSE: Successful repair of the orbital skeleton restores function and cosmesis by normalizing globe position and allowing full motility of the extraocular muscles. Routine repairs are successful with standard implants. However, defects that are irregular or cause volume deficiency can be challenging to repair. The development of patient specific implants (PSI) offers an additional tool in complex cases. Herein, we report our experience using PSI for orbital reconstruction. METHODS: An IRB-approved review was conducted of consecutive patients who received PSI from 8/2016–9/2018. Demographic and examination findings were recorded. PSI was designed using high-density porous polyethylene or polyetheretherketone (PEEK) and implanted for repair. The postoperative course was reviewed for outcomes and complications. RESULTS: Eight patients were identified. Two had silent sinus syndrome, 3 were complex facial fracture revisions, and 3 were post-oncologic reconstruction. Seven received porous polyethylene implants, and 1 had a PEEK implant. Mean follow up time was 10.2 months (3.3–28.3). All had an improved functional and aesthetic result. Diplopia and enophthalmos completely resolved in 60% of fracture and silent sinus patients. All fracture and silent sinus patients were orthotropic without diplopia in primary gaze at last follow up. Tumor patients had improvement in symmetry and functionality. There were no complications. CONCLUSION AND IMPORTANCE: Complex orbital skeleton derangements can be difficult to repair and standard implants may incompletely resolve the anatomic problem. In challenging cases, PSI may better achieve an aesthetically and anatomically successful outcome and improve functionality. |
format | Online Article Text |
id | pubmed-8554165 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-85541652021-11-05 Patient specific implants in orbital reconstruction: A pilot study() Habib, Larissa A. Yoon, Michael K. Am J Ophthalmol Case Rep Image PURPOSE: Successful repair of the orbital skeleton restores function and cosmesis by normalizing globe position and allowing full motility of the extraocular muscles. Routine repairs are successful with standard implants. However, defects that are irregular or cause volume deficiency can be challenging to repair. The development of patient specific implants (PSI) offers an additional tool in complex cases. Herein, we report our experience using PSI for orbital reconstruction. METHODS: An IRB-approved review was conducted of consecutive patients who received PSI from 8/2016–9/2018. Demographic and examination findings were recorded. PSI was designed using high-density porous polyethylene or polyetheretherketone (PEEK) and implanted for repair. The postoperative course was reviewed for outcomes and complications. RESULTS: Eight patients were identified. Two had silent sinus syndrome, 3 were complex facial fracture revisions, and 3 were post-oncologic reconstruction. Seven received porous polyethylene implants, and 1 had a PEEK implant. Mean follow up time was 10.2 months (3.3–28.3). All had an improved functional and aesthetic result. Diplopia and enophthalmos completely resolved in 60% of fracture and silent sinus patients. All fracture and silent sinus patients were orthotropic without diplopia in primary gaze at last follow up. Tumor patients had improvement in symmetry and functionality. There were no complications. CONCLUSION AND IMPORTANCE: Complex orbital skeleton derangements can be difficult to repair and standard implants may incompletely resolve the anatomic problem. In challenging cases, PSI may better achieve an aesthetically and anatomically successful outcome and improve functionality. Elsevier 2021-10-19 /pmc/articles/PMC8554165/ /pubmed/34746511 http://dx.doi.org/10.1016/j.ajoc.2021.101222 Text en © 2021 The Authors. Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Image Habib, Larissa A. Yoon, Michael K. Patient specific implants in orbital reconstruction: A pilot study() |
title | Patient specific implants in orbital reconstruction: A pilot study() |
title_full | Patient specific implants in orbital reconstruction: A pilot study() |
title_fullStr | Patient specific implants in orbital reconstruction: A pilot study() |
title_full_unstemmed | Patient specific implants in orbital reconstruction: A pilot study() |
title_short | Patient specific implants in orbital reconstruction: A pilot study() |
title_sort | patient specific implants in orbital reconstruction: a pilot study() |
topic | Image |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8554165/ https://www.ncbi.nlm.nih.gov/pubmed/34746511 http://dx.doi.org/10.1016/j.ajoc.2021.101222 |
work_keys_str_mv | AT habiblarissaa patientspecificimplantsinorbitalreconstructionapilotstudy AT yoonmichaelk patientspecificimplantsinorbitalreconstructionapilotstudy |