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A novel technique for placing titanium mesh with porous polyethylene via the endoscopic transnasal approach into the orbit for medial orbital wall fractures

Archives of Plastic Surgery 2019년 46권 5호 p.421 ~ 425
 ( Bae Seong-Hwan ) - Pusan National University School of Medicine Department of Plastic and Reconstructive Surgery

 ( Jeong Dae-Kyun ) - Pusan National University School of Medicine Department of Plastic and Reconstructive Surgery
 ( Go Ju-Young ) - TAE Plastic Surgery Clinic
 ( Park Hee-Seung ) - Pusan National University Hospital Busan Cancer Center
 ( Kim Joo-Hyoung ) - Pusan National University School of Medicine Department of Plastic and Reconstructive Surgery
 ( Lee Jae-Woo ) - Pusan National University School of Medicine Department of Plastic and Reconstructive Surgery
 ( Kang Tae-Woo ) - Pusan National University Hospital Busan Cancer Center

Abstract


Background: The endoscopic transnasal approach is widely used for reconstructing the medial orbital wall by filling it with a silicone sheet or Merocel, but this technique has the disadvantage of retaining the packing for a long time. To overcome this drawback, a method of positioning an absorbable plate in the orbit has been introduced, but there is a risk of defect recurrence after the plate is absorbed. Here, the authors report the results of a novel surgical technique of placing a nonabsorbable titanium mesh with porous polyethylene into the orbit through the endoscopic transnasal approach.

Methods: Fourteen patients underwent surgery using the endoscopic transnasal approach. Preoperative computed tomography (CT) was used to calculate the size of the bone defect due to the fracture, and the titanium mesh was designed to be shorter than the anteroposterior length of the defect and longer than its height. The titanium mesh was inserted into the orbit under an endoscopic view. The authors then confirmed that the titanium mesh supported the orbital contents by pressing the eyeball and finished the operation. Immediately after surgery, CT results were evaluated.

Results: Postoperative CT scans confirmed that the titanium mesh was well-inserted and in the correct position. All patients were discharged without any complications.

Conclusions: We obtained satisfactory results by inserting a titanium mesh with porous polyethylene into the orbit via the transnasal approach endoscopically.

키워드

Wound and injuries; Endoscopy; Orbit; General surgery; Titanium
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