title: Reconstruction of severe medial orbital wall fractures using titanium mesh plates placed using transcaruncular-transconjunctival approach: a successful combination of 2 techniques.
abstract: OBJECTIVE
  To prospectively evaluate the use of titanium mesh plates in a combined transcaruncular-transconjunctival approach for severe medial orbital wall fractures.
  
  
  METHODS
  We analyzed the clinical and radiologic data of 10 patients with isolated blow-out orbital fractures. The fracture location was the medial wall in 5 (50%) and the floor/medial wall in 5 (50%). Of the 10 patients, 8 (80%) were treated using 3-dimensionally preformed orbital titanium mesh plates and 2 (20%) with nonpreformed radial orbital mesh plates fixed at the inferior orbital rim with 1 or 2 monocortical screws (diameter 1.3 mm).
  
  
  RESULTS
  All the patients had satisfactory and anatomically correct orbital wall reconstruction as assessed on the immediate postoperative computed tomography scan. None of the patients experienced ophthalmic complications related to the transcaruncular-transconjunctival approach or developed enophthalmos as determined using Hertel exophthalmometry. One patient (10%) developed a nonhandicapping diplopia related to post-traumatic muscular contusion of the medial rectus muscle.
  
  
  CONCLUSIONS
  The present study has demonstrated that titanium mesh plates placed using a combined transcaruncular-transconjunctival approach for the reconstruction of severe medial orbital wall fractures results in a high rate of success.
authors.affiliation: Department of Surgery, Hôpitaux Universitaire de Genève Faculty of Medicine, Geneva, Switzerland. paolo.scolozzi@hcuge.ch
authors.forename: Paolo
authors.initials: P
authors.lastname: Scolozzi
mesh_terms: D000293:Adolescent; D000328:Adult; D001672:Biocompatible Materials; D001860:Bone Plates; D001863:Bone Screws; D003228:Conjunctiva / Q000601:surgery; D003288:Contusions / Q000150:complications; D004172:Diplopia / Q000209:etiology; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D009801:Oculomotor Muscles / Q000293:injuries; D009915:Orbit / Q000601:surgery; D009917:Orbital Fractures / Q000145:classification / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013526:Surgical Mesh; D014025:Titanium; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D014025:Titanium