Quality of life after reconstruction of traumatic orbital floor defects using titanium mesh and medpore: A randomised controlled trial

Gupta, Sarika; Mehrotra, Divya; Singh, Prince Kumar; Vignesh, U; Bhave, Sujay Milind; Katrolia, Ravi

doi:10.1016/j.jobcr.2021.01.012

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…Some scholars utilized 3-dimensional printing technology to generate customized anatomical models, enabling precise orbital reconstructive preoperative planning is now possible. 22,23,25,26 Therefore, 3-dimensional printing is a promising and cost-efficient supporting tool that can improve the outcome of complex and demanding orbital wall reconstructions.…”

Section: Discussionmentioning

confidence: 99%

“…Results of studies conducted over the past 10 years have shown that these grafts are safe and improve the symptoms of diplopia and enophthalmos. However, due to the 3-dimensional curvature of the orbital wall, the handling of bone grafts is not easy and usually requires a lot of time and effort 22,23 . Choi JS 18 used the iliac crest to reconstruct the medial orbital wall and achieved good results, but the iliac crest carving was relatively difficult and time-consuming, and increased wounds on the body surface affected the appearance.…”

Section: Discussionmentioning

confidence: 99%

“…At present, the shape of the implant needs to be compared and trimmed with the defect repeatedly during the operation, which cannot be repaired accurately and finely, which affects the operative time and postoperative effect. Some scholars utilized 3-dimensional printing technology to generate customized anatomical models, enabling precise orbital reconstructive preoperative planning is now possible 22,23,25,26 . Therefore, 3-dimensional printing is a promising and cost-efficient supporting tool that can improve the outcome of complex and demanding orbital wall reconstructions.…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction of Medial Orbital Wall Using Autologous Perpendicular Plate of Ethmoid

Zhang,

Xu,

Zhang

et al. 2023

Journal of Craniofacial Surgery

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The aim of this study is to investigate the feasibility of perpendicular plate of ethmoid as material for the reconstruction of medial orbital wall. The main outcome measurement was preoperative and postoperative orbital volume. The authors performed a study including 17 patients who have isolated medial orbital wall fracture (blow-out fracture). All the patients were fixed the defect using autologous perpendicular plate of ethmoid under endonasal approach. The authors compared the preoperative and postoperative orbital volume difference (unaffected orbit, affected orbit) of all the patients, and observed the improvement of diplopia or ocular motility disorders after operation. All 17 medial orbital wall reconstruction surgeries were successful with no severe postoperative ophthalmic complications. Statistically significant differences were found between the preoperative and postoperative orbital tissue volumes for the affected orbit. There was no statistically significant difference found between the tissue volume of the contralateral unaffected orbit and the affected orbit after reconstruction. And postoperative computed tomography showed the implant is in place and there is no medial rectus incarceration. Autologous perpendicular plate of ethmoid proved to be safe and effective in the reconstruction of medial orbital wall under endonasal approach with cost-effectivence, low complication rate, high biocompatibility, and minimally invasion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Reconstruction of Medial Orbital Wall Using Autologous Perpendicular Plate of Ethmoid

Zhang,

Xu,

Zhang

et al. 2023

Journal of Craniofacial Surgery

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“…We performed a systematic risk of bias assessment to identify bias for each included trial. Nine studies [28,29,[31][32][33][34][35][36][37] had a high risk of bias, and one study [30] had an unclear risk. The risk of bias in individual studies and across the included studies is summarized in Figure 2.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…Gupta et al [37] assigned success scores to the reconstruction, enophthalmos correction, diplopia correction, and hypoglobus correction. They also evaluated the quality of life with a questionnaire.…”

Section: Correction Of Orbital Dystopiamentioning

confidence: 99%

Is the Pre-Shaping of an Orbital Implant on a Patient-Specific 3D-Printed Model Advantageous Compared to Conventional Free-Hand Shaping? A Systematic Review and Meta-Analysis

Singh

Khanal

Chaulagain

et al. 2023

JCM

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This study aimed to perform a systematic review and meta-analysis to compare pre-shaped implants on a patient-specific 3D-printed (3DP) model to manual free-hand shaping (MFS) for orbital wall reconstruction. The PRISMA protocol was followed in this study, and the review was registered in the PROSPERO database (CRD42021261594). A search was conducted in MEDLINE (PubMed), Embase, Cochrane Library, Clinicaltrials.gov, Google Scholar, and the grey literature. Ten articles were included, and six outcomes were analyzed. In total, 281 patients were in the 3DP group and 283 were in the MFS group. The studies had an overall high risk of bias. 3DP models resulted in a better accuracy of fit, anatomical angle reproduction, and defect area coverage. The correction of orbital volume was also superior with statistical significance. There was a higher percentage of the correction of enophthalmos and diplopia in the 3DP group. Intraoperative bleeding and hospital stay were reduced in the 3DP group. The meta-analysis of operative time showed a reduction in the average operative time by 23.58 min (95% CI: −43.98 to −3.19), which was statistically significant (t(6) = −2.8299, p = 0.0300). The 3DP models appear advantageous for an accurate orbital wall reconstruction, with fewer complications than those for conventional free-hand-shaped implants.

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Orbital reconstruction: a systematic review and meta-analysis evaluating the role of patient-specific implants

Kotecha

Ferro

Harrison

et al. 2022

Oral Maxillofac Surg

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The purpose of this study is to execute an evidence-based review answering the following question (PICO): “Do patient-specific implants (PSI), manufactured or designed using computer-assisted technology, improve outcomes (orbital volume change, enophthalmos, diplopia, and operative duration) compared to conventional methods in orbital reconstruction following traumatic orbital injury in the adult patient population?” We performed a systematic review and meta-analysis in accordance with PRISMA guidelines. Inclusion criteria included any comparative paper whereby computer-assisted technology was used in the prefabrication or design process of implants for use in post-traumatic orbital reconstruction. Paediatric patient populations were excluded. Eight databases were systematically searched for relevant studies. Risk of bias was assessed through the NOS and RoB2 tools. Random-effects models were used to identify differences in outcomes between groups where possible. Analysis was performed using R 4.0.0. Eleven of 4784 identified studies were included, comprising 628 adult patients, with 302 and 326 patients in the patient-specific and conventional groups, respectively. Weighted mean difference between unaffected and post-operative orbital volume was 0.32 ml (SD 0.75) and 0.95 ml (SD 1.03) for patient-specific and conventional groups, respectively. Significant improvement was identified in post-operative orbital volume reconstitution with the use of PSI, compared to conventional implants, in 3 of the 5 reporting studies. Equally, post-operative enophthalmos trended towards lower severity in the patient-specific group, with 11.2% of patients affected in the patient-specific group and 19.2% in the conventional group, and operative duration was significantly reduced with the use of PSI in 3 of the 6 reporting studies. Despite a tendency to favour PSI, no statistically significant differences in key outcomes were identified on meta-analysis. Although there is some encouraging data to support improved outcomes with the use of patient-specific orbital implants in post-traumatic reconstruction, there is, at present, no statistically significant evidence to objectively support their use over conventional implants based on the currently available comparative studies. Based on the results of this study, the choice of implant used should, thus, be left to the discretion of the surgeon.

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Quality of life after reconstruction of traumatic orbital floor defects using titanium mesh and medpore: A randomised controlled trial

Cited by 5 publications

References 17 publications

Reconstruction of Medial Orbital Wall Using Autologous Perpendicular Plate of Ethmoid

Reconstruction of Medial Orbital Wall Using Autologous Perpendicular Plate of Ethmoid

Is the Pre-Shaping of an Orbital Implant on a Patient-Specific 3D-Printed Model Advantageous Compared to Conventional Free-Hand Shaping? A Systematic Review and Meta-Analysis

Orbital reconstruction: a systematic review and meta-analysis evaluating the role of patient-specific implants

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