Assessing the Adequacy of Orbital Reconstruction With Titanium Mesh Using Clinical and Radiological Measures

Cureus. 2024 Sep 27;16(9):e70324. doi: 10.7759/cureus.70324. eCollection 2024 Sep.

Abstract

Background Orbital reconstruction aims to restore the original orbit volume and correct diplopia, enophthalmos, and ocular motility of the fractured orbit. This study aimed to assess the adequacy of orbital reconstruction using radiological and clinical factors. Methods In this retrospective study, patients with orbital blowout fractures meeting clinical or radiographic criteria underwent orbital reconstruction with titanium mesh. The orbital volume and anteroposterior displacement were calculated pre- and post-operatively using computed tomography. Diplopia, inferior orbital nerve examination, and ocular movement were also evaluated. Pre- and post-operative orbital volumes of the fractured and contralateral unfractured orbits were compared. Statistical analysis was performed using MS Excel (Redmond, USA) and STATA BE (Texas, US). Results There was a significant reduction in the difference in volumes between fractured and normal orbits postoperatively (p-value <0.001). The mean difference between the reconstructed orbital floor fracture and the contralateral normal orbit was 0.55 cm3, which is within the normal anatomic variation. Enophthalmos was corrected postoperatively in our patients per radiological parameters as a result of a reduction in the mean posterior displacement. Infraorbital nerve hypoesthesia was not resolved postoperatively. Conclusion Our study highlights the restoration of the normal anatomical variation in volume differences between the fractured and contralateral orbits post-surgery using CT-guided analysis, thereby improving clinical outcomes.

Keywords: computed tomography; enophthalmos; orbit floor fracture; orbit reconstruction; volumetric analysis.