Comparative Study of Enophthalmos Treatment with Titanium Mesh Combined with Absorbable Implant vs. Costochondral Graft for Large Orbital Defects in Floor Fractures

Introduction: Several treatment options are available for the optimal treatment for orbital fractures, depending on aesthetic and functional results after orbital wall reconstruction. The objective of this study is to compare the effect and safety of large orbital fl oor fractures with titanium mesh combined with poly-L-lactic acid/polyglycolic acid copolymer implants (Lactosorb®) vs. autologous costochondral graft. A wide range of permanent and biodegradable materials have been used successfully for orbital fl oor reconstruction, however they present with disadvantages for reconstruction of large defects, even if combined. Patients and Methods: A retrospective cohort study of patients from Estado de México, México, with access to ISSEMYM health care service, presenting with orbital fl oor fracture treated at Department of Plastic & Reconstructive Surgery/Maxillofacial Surgery at ISSEMYM Medical Center Toluca between January 2007 and July 2010. Age, sex, etiology, clinical fi ndings, fracture pattern, and treatment modality (Titanium mesh with absorbable implant vs. costochondral graft) were considered. Predictor and outcome variables as complications, inpatient, traumasurgery interval, surgical time and donor site pain are considered. Results: Follow up of 21 patients (12 weeks) 17 male, 4 female, ages 22-63 was made. Enophthalmos, main objective of this study, was identifi ed with statistical signifi cance presenting 0% (n=0) post-op Group B patients and 30% (n=3) for Group A (p=0.049). Statistical signifi cance was found referring to inpatient days between two groups being less for costochondral reconstruction patients (p=0.02). No pain in patients undergoing alloplastic surgery. An interesting result was that donor area analogue pain scale for costochondral graft was 2.9/10. Conclusion: Surgical outcome and complications where evaluated comparing different materials for orbital fl oor reconstruction. Costochondral graft is a suitable choice when orbital reconstruction is indicated. Case Report Comparative Study of Enophthalmos Treatment with Titanium Mesh Combined with Absorbable Implant vs. Costochondral Graft for Large Orbital Defects in Floor Fractures Malagón Hidalgo*, Héctor Omar, González Magaña, Fernando, Kalach Mussali, Alberto Jaime, Mejía Valero, Sergio Abraham, Vilchis López, Roberto, Araiza Gómez and Edgardo Plastic and Reconstructive Department/Maxillofacial Surgery Department, Centro Médico ISSEMYM, Toluca, México *Address for Correspondence: Malagón Hidalgo, Plastic and Reconstructive Department, Maxillofacial Surgery Department, Avenida Baja Velocidad, 284 Km 57.5, San Jerónimo Chicahualco, Metepec, Estado de México, Tel: 722-275-6300. Ext. 2062; Email: [email protected] Submitted: 09 March 2017 Approved: 21 March 2017 Published: 23 March 2017 Copyright: 2017 Hidalgo M, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.