Orbital floor reconstruction with flexible Ethisorb patches: a retrospective long-term follow-up study.
OBJECTIVE
The purpose of the study was to investigate whether a flexible, biodegradable material (Ethisorb) shows better long-term results with regard to diplopia, bulbus motility, and exophthalmos/enophthalmos compared to the use of lyophilized dura-patches and polydioxanone (PDS) foils.


METHODS
During a period of 6 years 435 patients with an orbital fracture were investigated retrospectively. Inclusion criteria were patients with fractures of the orbital floor with a maximum size of 2 x 2 cm. Bulbus motility, exophthalmos, enophthalmos, and diplopia were investigated during a period of 2 years.


RESULTS
One hundred twenty orbital floors were reconstructed by lyophilized dura-patches, 81 by PDS, and 136 by Ethisorb. An exploration without an implantation was performed in 91 patients. The long-term investigation 12 to 15 months after surgery showed an exophthalmos and enophthalmos incidence of 1%, whereas a reduced bulbus motility and diplopia were found in 5% and 4%, respectively. Fifteen to 24 months after surgery 2% of the patients had an exophthalmos and 1% had an enophthalmos. A reduction of bulbus motility was found in 4% of the patients, and diplopia was found in 3%. The use of Ethisorb resulted in a significantly lower incidence of exophthalmos 3 months after surgery compared to PDS.


CONCLUSIONS
The low rate of acquired bulbus motility demonstrates acceptable results in using Ethisorb in the floor of the orbit.
Jank
Siegfried
S
Department of Oral and Maxillofacial Surgery, University of Innsbruck, Austria. siegfried.jank@gmx.de
Emshoff
Rüdiger
R
Schuchter
Barbara
B
Strobl
Heinrich
H
Brandlmaier
Iris
I
Norer
Burghard
B
D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D001672:Biocompatible Materials; D004172:Diplopia / Q000209:etiology / Q000517:prevention & control; D004388:Dura Mater / Q000637:transplantation; D015841:Enophthalmos / Q000209:etiology / Q000517:prevention & control; D005094:Exophthalmos / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000209:etiology / Q000517:prevention & control; D009915:Orbit / Q000601:surgery*; D009917:Orbital Fractures / Q000150:complications / Q000601:surgery*; D020273:Orbital Implants; D018583:Pliability; D016687:Polydioxanone; D011091:Polyesters; D011100:Polyglycolic Acid; D012189:Retrospective Studies
D001672:Biocompatible Materials; C460779:Ethisorb; D011091:Polyesters; D011100:Polyglycolic Acid; D016687:Polydioxanone