title: Biodegradable Fixation of the Orbital Rim After Lateral Orbitotomy.
abstract: OBJECTIVE
  To describe authors' experience with repair of the lateral orbital rim with poly-L/DL-lactic acid (PDLLA) biodegradable plates using ultrasonic pin fixation after lateral orbitotomy with bone flap.
  
  
  METHODS
  The authors retrospectively reviewed all patients who underwent a lateral orbitotomy with bone flap for biopsy of orbital tumors at their institution from January 2010 to May 2013. All patients underwent an orbitotomy by either a lateral eyelid crease incision or lateral canthotomy/cantholysis approach. A lateral bone flap was fashioned in the usual manner, extending from the frontozygomatic suture down the lateral rim for approximately 2 cm. The bone flap was repaired in each case with either a 6 or 7 hole PDLLA plate and secured with ultrasonic PDLLA pin fixation.
  
  
  RESULTS
  Twenty-four patients were identified who underwent a lateral orbitotomy with bone flap. Of these patients, 10 were repaired with PDLLA plates. The average age of the patients with PDLLA bone flap fixation was 55 years (range 5-85). The average follow-up time was 12.9 months (range 4-42). Indications included 4 lacrimal gland tumors, 4 intraconal tumors, and 2 lateral orbital tumors. Final diagnosis included lymphoma (3), squamous cell carcinoma (1), neuroblastoma (1), amyloid (1), fibrous tissue (1), sarcoidosis (1), cavernous hemangioma (1), and idiopathic orbital inflammation (1). Three patients had edema of the surrounding soft tissues after surgery, all but 1 resolved by postop month 3. There were 2 cases of transient temporal numbness that resolved by postop month 1. There were no cases of vision loss, extraocular motility deficit, infection, or need for removal of the implant before absorption.
  
  
  CONCLUSIONS
  PDLLA biodegradable plates with ultrasonic pin placement provide a safe, effective means for lateral rim fixation after orbitotomy with bone flap.
authors.affiliation: *Oculofacial Plastic and Orbital Surgery, University of Colorado Hospital, Aurora, Colorado, U.S.A.; †University of Rochester Medical Center, Rochester, New York, U.S.A.; and ‡Texas Oculoplastic Consultants, Austin, Texas, U.S.A.
authors.forename: Brett W
authors.initials: BW
authors.lastname: Davies
authors.forename: Reid A
authors.initials: RA
authors.lastname: Mollman
authors.forename: Mithra O
authors.initials: MO
authors.lastname: Gonzalez
authors.forename: Eric M
authors.initials: EM
authors.lastname: Hink
authors.forename: Vikram D
authors.initials: VD
authors.lastname: Durairaj
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D006801:Humans; D019344:Lactic Acid; D008875:Middle Aged; D009915:Orbit / Q000601:surgery*; D009918:Orbital Neoplasms / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D011100:Polyglycolic Acid; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D012189:Retrospective Studies; D013524:Surgical Flaps
chemical_list: D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid