title: Porous polyethylene implant reconstruction of the orbit after resection of spheno-orbital meningiomas: a novel technique.
abstract: BACKGROUND
  Spheno-orbital meningiomas (SOM) are complex tumors involving the middle cranial fossa and orbit. Following resection of these tumors, reconstruction of the orbit can be challenging. Inadequate reconstruction may lead to cosmetic deformities and functional complications.
  
  
  OBJECTIVE
  The development of a technique for orbital reconstruction which is technically straightforward, cost-effective, with an excellent functional and cosmetic outcome.
  
  
  METHODS
  Twelve patients with SOM each underwent a modified orbital-zygomatic craniotomy with osteotomies based on individual tumor location. After tumor resection, the lateral orbit and orbital roof, where necessary, were reconstructed using a 1 mm porous polyethylene sheet, customized to reconstruct the bony anatomy of the lateral and superior orbit and secured with 1.5×4 mm titanium screws into the orbital roof and rim.
  
  
  RESULTS
  All patients demonstrated stabilization or improvement of vision and satisfactory cosmetic outcomes. One complication (surgical site infection) was noted. Follow-up imaging was obtained at regular intervals. The resection cavity was easily visualized without interference from the implant in each case. One patient developed tumor recurrence requiring re-operation 20 months after the initial procedure.
  
  
  CONCLUSIONS
  Use of a 1mm porous polyethylene sheet for reconstruction of the lateral orbit offers an excellent functional and cosmetic outcome, does not interfere with postoperative imaging, is technically straightforward, and is cost-effective.
authors.affiliation: Department of Neurological Surgery, Vanderbilt University Medical Center, 1161 21st Avenue South, Nashville, TN 37232-2380, United States. lola.chambless@vanderbilt.edu
authors.forename: Lola B
authors.initials: LB
authors.lastname: Chambless
authors.forename: Louise A
authors.initials: LA
authors.lastname: Mawn
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Forbes
authors.forename: Reid C
authors.initials: RC
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D035301:Cranial Fossa, Middle; D003399:Craniotomy / Q000379:methods; D005260:Female; D006801:Humans; D008577:Meningeal Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D008579:Meningioma / Q000534:rehabilitation* / Q000601:surgery; D008875:Middle Aged; D009915:Orbit / Q000601:surgery*; D020273:Orbital Implants; D009918:Orbital Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D011095:Polyethylenes; D019919:Prosthesis Implantation; D019292:Skull Base Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D013100:Sphenoid Bone / Q000601:surgery; D015050:Zygoma / Q000601:surgery
chemical_list: D001672:Biocompatible Materials; C084562:Medpor; D011095:Polyethylenes