Abstract
Background Orbital blowout fractures are peculiar injuries causing disruption of both ocular
function and symmetry. We present our experience with the use of a precontoured titanium
mesh in orbital blowout fractures.
Methods A retrospective study of patients undergoing correction of orbital blowout fractures
with a precontoured titanium mesh was done at a tertiary care center in Mumbai. Data
regarding demographics and pre- and postoperative clinical and radiological attributes
were retrieved and compared.
Results A total of 21 patients (19 males and 2 females) underwent correction of blowout fractures
with a precontoured titanium mesh. The follow-up period ranged from 6 to 10 months.
Road traffic accident (76%) was the most common etiology. Twenty (95%) patients had
impure blowout fractures and 1 (5%) patient had a pure blowout. The orbital floor
was most commonly fractured (16 [76%]). Associated fractures of the zygomaticomaxillary
complex were found in 71% of patients. All patients were operated on within 3 weeks
of trauma. A comparison of the operated and uninjured sides on coronal views of computed
tomography (CT) scan in nine patients by Photopea application revealed a correction
of the increased cross-sectional area in all cases. Enophthalmos was completely corrected
in 94% patients, while 92% patients had complete correction of diplopia. One patient
with a comminuted zygomatic fracture had persistent diplopia and mild enophthalmos.
Infraorbital paresthesia persisted in 58% patients at 6 months of follow-up. No significant
postoperative complications were noted.
Conclusion The precontoured titanium mesh restores orbital wall anatomy and is safe, quick,
fairly easy, and reproducible with a shorter learning curve. With proper patient selection
and execution, prefabricated titanium mesh can serve as an excellent reconstructive
option in blowout fractures of the orbit.
Key-Words
blowout fracture - titanium mesh - precontoured titanium mesh - enophthalmos - orbital
floor
