Chronic orbital infection caused by migration of an orbital Silastic implant

Chronic Inflammation in an Anophthalmic Socket due to a Room Temperature Vulcanized Silicone Implant

Two case reports are used to illustrate the signs and symptoms, complications and treatments of chronic socket inflammation due to intraorbital implants. The ophthalmic examination, surgeries and treatments are documented. Two anophthalmic cases that underwent enucleation and multiple orbital surgeries to enhance the anophthalmic socket volume developed pain, intense discharge and contracted cavities with chronic inflammation in the socket which was nonresponsive to medical therapy. Computed tomography indicated a hypodense foreign body in both cases causing an intense inflammatory reaction. The implants were removed by excisional surgery and a room temperature vulcanized silicone implant was retrieved in both cases. Socket inflammation resolved in both cases after implant removal. An intraorbital inflammatory reaction against an intraorbital implant can cause chronic socket inflammation in patients with a history of multiple surgeries. Diagnosis requires imaging and the definitive treatment is implant removal.

Tarsal Coalitions: Preliminary Results After Operative Excision and Silicone Sheet Interposition in Children

Symptomatic tarsal coalitions that begin in early adolescence are usually treated by resection and interposition (fat, muscle, or bone wax) to prevent recurrence. The purpose of the present retrospective study was to describe our operative technique and report our clinical and radiologic outcomes with sterile silicone sheet interposition after resection of painful tarsal coalitions in 4 children (4 feet). The present series included 1 case of talocalcaneal synchondrosis and 3 of synostosis (2 talocalcaneal and 1 cuboid-navicular). Two validated functional scales were used to assess the patients' overall outcome and satisfaction with the procedure: the American Orthopaedic Foot and Ankle Society ankle-hindfoot score and the Foot Function Index. Conventional radiography, computed tomography with 3-dimensional reconstruction, and magnetic resonance imaging were performed at the final follow-up visit. The mean follow-up period was 40 (range 12 to 80) months. The mean age at surgery was 10.5 (range 8 to 13) years. All patients had achieved their desired activity level at 6 months postoperatively. The mean American Orthopaedic Foot and Ankle Society ankle-hindfoot score was 93.5 (range 74 to 100), and the mean Foot Function Index was 3.25% (range 0% to 13%). No recurrence of the coalition on imaging at the final follow-up visit was observed in this patient series. Sterile silicone sheet interposition can be used to prevent recurrence of tarsal coalition in symptomatic tarsal coalitions after failure of conservative management.

Complications of orbital floor repair with silastic sheet: the skin fistula

Treatment of orbital floor fracture is a subject of great interest in maxillofacial surgery. Many materials have been described for its reconstruction.In this article, the authors report a case of a patient who, 7 years from a previous orbital floor fracture and treatment with silastic sheet, presented herself to their clinic for the failure of the material used for its reconstruction and a skin fistula.Orbital floor repair with silastic sheet is an old method that no one uses anymore, but we still observe cases of late complications with this material. So a fine knowledge of silastic sheet complications is needed for young surgeons.The authors report the case and perform a literature review about the use of more modern biomaterials for orbital floor reconstruction.