Precision of Post-Traumatic Orbital Reconstruction Using Unsintered Hydroxyapatite Particles/Poly-L-Lactide Composite Bioactive/Resorbable Mesh Plate with and without Navigation: A Retrospective Study

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  • Sukegawa Shintaro
    Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital
  • Kanno Takahiro
    Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine
  • Koyama Yuta
    Division of Ophthalmology, Kagawa Prefectural Central Hospital
  • Matsumoto Kenichi
    Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital
  • Sukegawa-Takahashi Yuka
    Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital
  • Masui Masanori
    Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital
  • Tanaka Shigeto
    Division of Ophthalmology, Kagawa Prefectural Central Hospital
  • Furuki Yoshihiko
    Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital

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Abstract

<p>The purpose of this study was to assess the level of accuracy that can be achieved in patients undergoing orbital reconstruction for orbital floor defect accompanied by midfacial fracture using an unsintered hydroxyapatite particles/poly-L-lactide composite plate system with and without the use of intraoperative navigation. Eight consecutive patients treated using the u-HA/PLLA mesh plate system between 2014 and 2016 were included in this retrospective study. We analyzed the clinical and radiological data of these patients with orbital floor defect and midfacial fracture extending to the orbit. We examined the patients’ postoperative healing status, including visual activity, diplopia, and enophthalmos. The overall volume of the orbit was calculated in cubic millimeters and was compared between the reconstructed orbit and the uninjured orbit for with and without the use of navigation groups. No patients complained of visual problems, and no further treatment was required postoperatively. Except for one patient with persistence of slight supraversion diplopia in the group without navigation, all the preoperative diplopia symptoms postoperatively improved, and none of the patients complained of problems in daily living. There was a significant difference (p < 0.05) in the mean reconstructed orbital volume accuracy between with and without navigation. In conclusion, complex orbital reconstruction using optimal bioactive/resorbable material with intraoperative navigation is an accurate and reliable method of reconstruction.</p>

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