Abstract
Purpose
Reconstruction of the bony orbit in patients with combined midface injuries is a frequently
discussed topic in the current literature. Two main concepts can be distinguished:
single-stage reconstruction, usually with a hand-bent titanium orbital mesh, or two-stage
reconstruction, in which osteosynthesis of the ZMC is followed by orbital reconstruction
with a virtually planned patient-specific titanium implant in a second surgery. This
study aims to compare one- and two-stage surgical approaches on combined midface fractures
regarding postoperative diplopia.
Methods
58 patients treated with either a one-stage (29) or a two-stage (29) reconstruction
of the ZMC and the orbit were included in this study and their postoperative course
over five months was retrospectively analyzed.
Results
A descriptive quantitative analysis recording the course of occurence of diplopia
was recorded to calculate the success of orbital repair in complex midface fractures
including the orbit. The two presented workflows differed in the prevalence of postoperative
clinical diplopia and eyelid complications.
Conclusions
There are multiple factors affecting the decision whether or not to reconstruct the
orbit firsthand and in the same intervention as the associated midface fracture. Thorough
evaluation of each individual patient and patient-specific choice of surgical concept
are crucial and include multiple factors.
Keywords
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Article info
Publication history
Accepted:
March 8,
2023
Received in revised form:
March 1,
2023
Received:
October 18,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
