What Is the Incidence of Implant Malpositioning and Revision Surgery After Orbital Repair?

Schlittler, Fabian; Schmidli, Andre; Wagner, Franca; Michel, Chantal; Mottini, Matthias; Lieger, Olivier (2018). What Is the Incidence of Implant Malpositioning and Revision Surgery After Orbital Repair? Journal of oral and maxillofacial surgery, 76(1), pp. 146-153. Elsevier 10.1016/j.joms.2017.08.024

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PURPOSE

Postoperative radiographic examinations are the gold standard in maxillofacial surgery, except in orbital reconstruction. Therefore, the purpose of this study was to estimate the frequency of implant malposition and revision operation after orbital repair.

MATERIALS AND METHODS

This retrospective cohort study was conducted in a level I trauma center at the University Hospital in Bern, Switzerland. To assess the incidence of malpositioning, a qualitative analysis of postoperative computed tomography scans, as well as comparative volumetric measurements of the orbits, was conducted. Furthermore, the incidence of and reason for secondary revision procedures were evaluated.

RESULTS

From September 2008 to December 2015, a total of 71 emergency patients (73 implants) were treated at the Department of Cranio-Maxillofacial Surgery with a titanium mesh (49 male patients; mean age, 56 years). The implant position was rated as poor in 17 cases (23%) by the qualitative analysis. The volumetric assessment showed no significant results. Revision intervention was needed in 12 patients (17%) because of an unsuccessful treatment outcome causing relevant clinical symptoms.

CONCLUSIONS

Patients with large orbital defects who require surgical treatment with a titanium mesh are at risk of implant malposition. Because in this study, poor positioning of the implant is the main reason for surgical revision, we postulate that a postoperative radiographic control should be obtained routinely. Only then can long-term sequelae due to inadequate reconstruction be avoided.

Item Type:

 Journal Article (Original Article)

Division/Institute:

 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Schädel-, Kiefer- und Gesichtschirurgie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Schädel-, Kiefer- und Gesichtschirurgie
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Craniomaxillofacial Surgery
04 Faculty of Medicine > Faculty Institutions > Teaching Staff, Faculty of Medicine
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

 Schlittler, Fabian, Wagner, Franca, Michel, Chantal, Mottini, Matthias, Lieger, Olivier

Subjects:

 600 Technology > 610 Medicine & health

ISSN:

 0278-2391

Publisher:

 Elsevier

Language:

 English

Submitter:

 Martin Zbinden

Date Deposited:

 09 Nov 2017 12:43

Last Modified:

 05 Dec 2022 15:07

Publisher DOI:

 10.1016/j.joms.2017.08.024

PubMed ID:

 28916325

BORIS DOI:

 10.7892/boris.105474

URI:

 https://boris.unibe.ch/id/eprint/105474

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