Effectiveness of operative treatment of internal orbital wall fracture with polydioxanone implant

• Published in: International journal of oral and maxillofacial surgery Vol. 30; no. 4; pp. 278 - 285
• Main Authors: Kontio, R., Suuronen, R., Salonen, O., Paukku, P., Konttinen, Y.T., Lindqvist, C.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.08.2001; Elsevier
• Subjects: Absorbable Implants - adverse effects; Adolescent; Adult; biodegradable implant; Biological and medical sciences; Diplopia - etiology; Emphysema - etiology; Enophthalmos - etiology; Exophthalmos - etiology; Female; Fibrosis - etiology; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Ophthalmology; orbit; Orbit - surgery; Orbit diseases; Orbital Fractures - diagnostic imaging; Orbital Fractures - surgery; Polydioxanone - adverse effects; Prospective Studies; reconstruction; Reconstructive Surgical Procedures - instrumentation; Reconstructive Surgical Procedures - methods; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Tomography, X-Ray Computed; reconstruction; biodegradable implant; orbit; Performance evaluation; Biodegradability; Vision disorder; Diseases of the osteoarticular system; Fracture; Anatomical reconstruction; Orbit(eye); Eyelid disease; Surgery; Adult; Diplopia; Evolution; Biomaterial; Biomedical engineering; Human; Postoperative; Radiodiagnosis; Implant; Treatment efficiency; Ptosis; Orbit(eye) disease; Exploration; Trauma; Nuclear magnetic resonance imaging; Symptomatology; Eye disease; Enophthalmus; Treatment; Medical imagery; Computerized axial tomography; Technique
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1054/ijom.2001.0067

Many implants, some made from teflon or silicone, have been used for internal orbital wall reconstruction. Late complications relating to use of such implants have been reported. In this prospective study a polydioxanone (PDS) implant absorbable in vivo was used for internal orbital wall reconstruction. Follow-up involved clinical examination, magnetic resonance imaging (MRI) and computerized tomography (CT). Clinical examinations were undertaken before operation and up to 36 weeks postoperatively. Sixteen consecutive patients (10 pure blow-out fractures, six with associated zygomatic fracture) took part in the study. Prevalences of diplopia, proptosis and enophthalmus were recorded during each follow-up examination. This study revealed no muscle entrapment within the fracture line. Although CT results confirmed bone growth in the internal orbital wall, shape was unsatisfactory, and orbital volume was not reduced. MRI revealed thick scar formations in six cases (37.5%), fibrotic sinuses filled with air or gas in three cases (19%) and a fibrotic sinus with fluid around the PDS in one case (6%). Our results suggest that use of PDS in reconstructing the internal orbital wall is inadvisable.