Navigation-Assisted Isolated Medial Orbital Wall Fracture Reconstruction Using an U-HA/PLLA Sheet via a Transcaruncular Approach

Abstract

Purpose: We investigated the feasibility of isolated medial orbital wall fracture reconstruction using an unsintered hydroxyapatite particles/poly L-lactide (u-HA/PLLA) sheet implant with the assistance of intraoperative navigation via the transcaruncular approach. Patients and methods: Ten consecutive patients (5 males and 5 females; mean age, 57.5 years) were included based on the clinical and imaging criteria. All patients underwent surgical treatment of the isolated medial orbital wall fracture using transcaruncular incision and the u-HA/PLLA implant under navigation. The follow-up time was greater than 6 months. Preoperative and postoperative clinical data regarding the presence of diplopia, eye motility restriction, and enophthalmos were assessed. The orbital volumes of the injured and uninjured orbit were also evaluated using computed tomography images. Results: All patients had improved ophthalmologic functional and esthetic outcomes and were successfully treated without any long-term complications arising during follow-up. There was a significant difference between the preoperative and postoperative injured orbits due to herniation of the orbital contents. Moreover, the orbital volume of the postoperative injured side following surgery was the same as that of the unaffected side, indicating that anatomically good reconstruction had been obtained. Conclusions: Surgical treatment using the transcaruncular approach and u-HA/PLLA materials with intraoperative navigation is a safe, promising, and effective technique for isolated medial orbital wall fracture reconstruction.

Keywords:

• transcaruncular approach
• medial orbital wall fracture
• u-HA/PLLA

This article is referred to by:

The Reconstruction of the Medial Wall of the Orbit: A Change in Philosophy

ACKNOWLEDGMENT

We would like to thank our colleagues in the Department of Ophthalmology, Shimane University Hospital (Director and Head: Prof. Masaki Tanito, MD, PhD) for their assistance with the clinical examinations, patient evaluations, and follow-up.

Declaration of interest

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported in part by a JSPS KAKENHI Grant-in-Aid for Scientific Research (C) [grant Number: 17K11803], awarded to Dr. T.K. This clinical research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.