Radiologic and Facial Morphologic Long-Term Results in Treatment of Orbital Floor Fracture With Flexible Absorbable Alloplastic Material

Purpose: Although orbital floor fractures are frequently treated by the Ethisorb patch or polydioxanone foil, the utility of these treatments in extensive fractures remains controversial. The purpose of this study was to examine objectively the extent to which such flexible absorbable materials can restore orbital geometry in comminuted and defect fractures. Materials and Methods: Twenty-one patients with isolated comminuted or defect fractures of the orbital floor (mean, 4.32 cm(2)) were recruited for this retrospective study. Using an infraorbital approach, 15 patients received an Ethisorb patch, whereas polydioxanone foil (0.25 mm) was used in the remaining cases. Follow-up examinations with cone-beam computed tomography and 3-dimensional facial scanning occurred on average 27.4 months postoperatively. Orbital heights and volumes were measured on the fracture side and compared with the unaffected side. Based on 3-dimensional facial scan data, the ocular bulb position was assessed in the sagittal and vertical directions. For all parameters, the difference between the left and right sides was calculated, which was statistically significant compared with the side difference of an age-and gender-matched control group using unpaired t test (P < .05). Results: No statistically significant differences were observed in any variable between the surgical and control cohorts. A decreased diplopia rate of 38.14% was attained by the surgical intervention. Conclusion: The reconstruction of moderate to extensive orbital floor fractures can be provided with polydioxanone foil or the Ethisorb patch without significant changes in orbital geometry. (C) 2012 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 70:2375-2385, 2012