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E. Lupi, E. Iacomino, F. Romani, P. Balercia; Biomaterials in the Reconstruction of the Defects of the Orbital Roof . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5718.
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Purpose: Loss of substance of the orbital floor often occurs in connection with orbital or cranial base tumors and injuries of the facial skeleton. The primary reconstruction of this structure is performed in order to avoid complications like enophtalmus, defects of the superior rectus muscle or infections. The employ of autologus bone is always favorable but the use of biomaerials permit to minimize operating time and simplificate the procedure.The purpose of the present work is to present the experience of the Maxillo Facial Division Ospedali riuniti Umberto I Ancona (Italy) in orbital roof reconstruction. Methods: Twenty one patients were reconstructed with implant placement. Eleven were submitted to surgery to repair loss of substance of the orbital roof followig demolitions for tumors of the orbit or frontal bone. The other nine patients were treated for trauma of the upper third of the facial skeleton. Medpore implants were used in nine cases, pericardium sheets in six cases, titanium mash in four and resorbable sheet in two patients. Results: There were no intraoperative complications. In one case there was, six month after surgery, infection of the pericardium sheet whit conseguent orbital cellulitis that required the reintervention. In nineteen patients the enophtalmos was corrected. No migrations or extrusion were reported. Conclusions: The study suggests that the primary reconstruction of the orbital roof is very important to avoid complications. Respect other allpolastic materials, titanium mash is more indicated in the largest loss of substance, when there is the need of more support in according with the frontal sinus grafting. We prefer resorbable materials in childhood. Medpore is favorable if the reconstruction include the orbital contour.
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