Orbital Roof Reconstruction
Porous polyethylene medpor has been used for many years in reconstructive surgeries and it is superior to other allografts in many ways.
Orbital roof reconstruction. The intraoperative technique is standard fronto orbital reconstruction as seen immediately after bony removal f during reconstruction g and at completion of reconstruction h. The latter can be observed in cases where resorbable implants were used or in cases where a thin wafer of silicone or porous polyethylene was used for reconstruction of large orbital wall defects. Zimmerer nils claudius gellrich in facial trauma surgery 2020. Alternatively matrix midface screws can be used.
Orbital process of the frontal bone anterior superior portion lesser wing of the sphenoid postero. The patients were satisfied with the external appearance in conclusion the orbital roof reconstruction using porous polyethylene sheet with embedded titanium was an easy and a time efficient. Reconstruction of orbital walls rims forehead nasoethmoid complex following intra and extracranial excision of benign tumor of cranial bone eg fibrous dysplasia with multiple autografts includes obtaining grafts. A coronal incision with frontal craniotomy provides a sufficiently wide exposure for dural repair and orbital roof reconstruction.
Most roof fractures are associated with other orbital fractures and result from significant head trauma as a high degree of force is required to fracture this portion of the orbit. 4 greater wing of sphenoid. After orbital reconstruction was indicated based on clinical and radiological findings video 1 3 1 the patient was treated with a patient specific orbital implant ips orbit kls martin tuttlingen germany following preparation of a transconjunctival retroseptal approach the patient. After completing neurosurgical repair the damaged orbital roof can be reduced and reconstructed.
Ct anatomy of the orbit. 1 superior orbital fissure. Inadequate insufficient reconstruction of the orbital floor may lead to a hammock shape contour. In our case the orbital roof reconstruction was done by medpor and the early and late.
Cpt code 21183 in section. Reconstruction of the orbital roof is the key step of the surgical treatment and should be performed in every case. The anterior fossa is exposed extradurally with visualization of the anterior two thirds of the orbital roof. Autogenous substances such as the calvarium rib and ilium are difficult to mold to the anatomical contours of.
Isolated orbital roof fractures in adults are uncommon comprising 12 19 of all orbital wall fractures. Orbital roof fracture icd 801 01 etiology. Fixation of orbital reconstruction material varies with the type and nature of the fracture. Fixation of most materials in the orbital roof is achieved by the use of one or more screws.