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Wu KY, Fujioka JK, Daigle P, Tran SD. The Use of Functional Biomaterials in Aesthetic and Functional Restoration in Orbital Surgery. J Funct Biomater 2024; 15:33. [PMID: 38391886 PMCID: PMC10889948 DOI: 10.3390/jfb15020033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
The integration of functional biomaterials in oculoplastic and orbital surgery is a pivotal area where material science and clinical practice converge. This review, encompassing primary research from 2015 to 2023, delves into the use of biomaterials in two key areas: the reconstruction of orbital floor fractures and the development of implants and prostheses for anophthalmic sockets post-eye removal. The discussion begins with an analysis of orbital floor injuries, including their pathophysiology and treatment modalities. It is noted that titanium mesh remains the gold standard for orbital floor repair due to its effectiveness. The review then examines the array of materials used for orbital implants and prostheses, highlighting the dependence on surgeon preference and experience, as there are currently no definitive guidelines. While recent innovations in biomaterials show promise, the review underscores the need for more clinical data before these new materials can be widely adopted in clinical settings. The review advocates for an interdisciplinary approach in orbital surgery, emphasizing patient-centered care and the potential of biomaterials to significantly enhance patient outcomes.
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Affiliation(s)
- Kevin Y Wu
- Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrook, QC J1G 2E8, Canada
| | - Jamie K Fujioka
- Faculty of Medicine, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Patrick Daigle
- Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrook, QC J1G 2E8, Canada
| | - Simon D Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC H3A 1G1, Canada
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Lubamba GP, Dai X, Song Z, Al-Shujaa EA, Guan J, Wang X, Isouradi-Bourley JPS, Zhang Y, Milolo AM, Bushabu FN, Xu P, Che D. Assessment of quality of life in patients treated for orbital fractures. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101486. [PMID: 37105493 DOI: 10.1016/j.jormas.2023.101486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE This study aimed to assess the quality of life (QOL), before and after surgery, of patients who underwent open reduction and internal fixation for orbital fractures. STUDY DESIGN A prospective study. PARTICIPANTS AND SETTING The self-report outcome measures of 50 patients treated at the Department of Oral and Maxillofacial Surgery of the Second Affiliated Hospital of Jiamusi University from January 2016 to June 2019 were prospectively collected. MAIN MEASURES The quality of life was assessed using four patient-reported outcome measures (PROMs): the 15D questionnaire, Oral Health Impact Profile-14 (OHIP-14), Hospital Anxiety and Depression Scale (HADS), and 36-item Short Form Survey (SF-36). Both descriptive and comparative data analyses were calculated. RESULTS Zygomaticomaxillary complex fractures were the most encountered (40.3%). The total OHIP-14 scores before and after treatment were 1.72 and 1.68, respectively. Vision, breathing, sleeping, eating, usual activities, discomfort and symptoms, and vitality showed minimal changes in the 15D questionnaire. The HADS scores were ranged from 0 to 7, indicating no anxiety or depression. The comparison of SF-36 scores after 3 months and after ≥6 months of treatment revealed no significant difference. CONCLUSIONS Patients' QOL was minimally impacted by orbital fractures and their treatments. The severity of the negative impact can be minimized if appropriate management strategies are taken.
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Affiliation(s)
- Grace Paka Lubamba
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China; Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, People's Republic of Congo; Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xinpeng Dai
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Zhenyu Song
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Eissa A Al-Shujaa
- Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jian Guan
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China.
| | - Xinyu Wang
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | | | - Yanqi Zhang
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Augustin Mantshumba Milolo
- Department of Prosthodontics, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, People's Republic of Congo
| | - Fidele Nyimi Bushabu
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, People's Republic of Congo
| | - Pengkun Xu
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Di Che
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
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Gu L, Huang R, Ni N, Gu P, Fan X. Advances and Prospects in Materials for Craniofacial Bone Reconstruction. ACS Biomater Sci Eng 2023; 9:4462-4496. [PMID: 37470754 DOI: 10.1021/acsbiomaterials.3c00399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
The craniofacial region is composed of 23 bones, which provide crucial function in keeping the normal position of brain and eyeballs, aesthetics of the craniofacial complex, facial movements, and visual function. Given the complex geometry and architecture, craniofacial bone defects not only affect the normal craniofacial structure but also may result in severe craniofacial dysfunction. Therefore, the exploration of rapid, precise, and effective reconstruction of craniofacial bone defects is urgent. Recently, developments in advanced bone tissue engineering bring new hope for the ideal reconstruction of the craniofacial bone defects. This report, presenting a first-time comprehensive review of recent advances of biomaterials in craniofacial bone tissue engineering, overviews the modification of traditional biomaterials and development of advanced biomaterials applying to craniofacial reconstruction. Challenges and perspectives of biomaterial development in craniofacial fields are discussed in the end.
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Affiliation(s)
- Li Gu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Rui Huang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Ni Ni
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Ping Gu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Xianqun Fan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
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Rosette J, Eslier M, Boutros M, Garmi R, Benateau H, Veyssiere A. Towards an evolution in ambulatory surgery for orbital floor repair? Our experience over a period of 11 years. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e874-e877. [PMID: 36057524 DOI: 10.1016/j.jormas.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Orbital floor fracture repair is a complex surgery with intra-orbital hematoma being the most feared complication as it can lead to visual loss if not treated in good time. This is why currently patients are monitored for almost 48 hours as inpatients. The purpose of this study was to find out if orbital floor repair surgery could be safely undertaken as a day case by reviewing the experience of the last 11 years at the Caen University Hospital. MATERIALS AND METHODS A retrospective, monocentric study was conducted at the Caen University Hospital. All patients undergoing orbital floor reconstruction in a trauma setting from January 2008 to December 2019 were included. RESULTS Of the 130 included patients, none presented a post-operative complication such as intra-orbital hematoma. 3 patients had their surgery performed as a day case. DISCUSSION In the literature, more and more surgeons are proposing orbital floor fracture repair to be undertaken as day case. Indeed, the theoretical risk of intra-orbital hematoma is greater within the first 6 hours after surgery and can persist up to 10 days postoperatively. Provided patients meet the classic criteria for outpatient surgery, and are provided with a precise post-operative care protocol. Under these conditions, orbital floor fractures may be repair in ambulatory surgery.
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Affiliation(s)
- Jeanne Rosette
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital 14000 Caen, France.
| | - Maxime Eslier
- University of Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France; Department of Obstetrics and Gynaecology, University of Caen Hospital 14000 Caen, France
| | - Mariam Boutros
- Department of Anaesthesiology, Caen University Hospital 14000 Caen, France
| | - Rachid Garmi
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital 14000 Caen, France
| | - Hervé Benateau
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital 14000 Caen, France; Normandie Univ, Unicaen, Bioconnect, 14000 Caen, France; Medecine Faculty of Caen, University of Caen Basse Normandie, 14032 Caen Cedex 5, France
| | - Alexis Veyssiere
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital 14000 Caen, France; Normandie Univ, Unicaen, Bioconnect, 14000 Caen, France; Medecine Faculty of Caen, University of Caen Basse Normandie, 14032 Caen Cedex 5, France
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Modabber A, Winnand P, Hölzle F, Ilgner J, Hackenberg S. [Current developments in primary and secondary surgical treatment of midface and periorbital trauma]. HNO 2022; 70:756-764. [PMID: 36044058 DOI: 10.1007/s00106-022-01226-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 11/04/2022]
Abstract
Fractures of the periorbita and the midface are among the most common bony facial injuries. Aesthetic and functional reconstruction is a challenge in clinical routine. This article illustrates recent developments in the primary and secondary surgical treatment of midface and periorbital trauma. Resorbable patches and films increase the anatomic reconstructive capacity and enable treatment of extensive orbital fractures. Orbital fractures with involvement of supporting key structures are advantageously reconstructed using patient-specific implants (PSI), which are fabricated by computer-assisted manufacturing techniques and positioned by intraoperative navigation. If late complications such as bulbar malposition and enophthalmos have occurred after the initial procedure, they can be addressed by overcorrective restoration of orbital volume. The use of PSI for initial fracture restoration of the midface is not yet established but may be useful in re-osteotomies of misconsolidated fragments. Extensive midface defects with significant soft tissue involvement can be reconstructed using microvascular grafts. Consecutive reconstructive procedures may include orthognathic surgery and local flap reconstruction. In summary, the integration and advancement of computer-assisted techniques now offers individualized reconstruction procedures, which may be a viable alternative to conventional implants and compression miniplates. Future developments may focus on the search for innovative biomaterials, which can be integrated into computer-aided design and manufacturing processes.
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Affiliation(s)
- A Modabber
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
| | - P Winnand
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - F Hölzle
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - J Ilgner
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinik RWTH Aachen, Aachen, Deutschland
| | - S Hackenberg
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinik RWTH Aachen, Aachen, Deutschland
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Tomic J, Wallner J, Mischak I, Sendlhofer G, Zemann W, Schanbacher M, Hassanzadeh H, Sandner-Kiesling A, Payer M, Zrnc TA. Intravenous ibuprofen versus diclofenac plus orphenadrine in orthognathic surgery: a prospective, randomized, double-blind, controlled clinical study. Clin Oral Investig 2022; 26:4117-4125. [PMID: 35103836 PMCID: PMC9072507 DOI: 10.1007/s00784-022-04381-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/13/2022] [Indexed: 11/26/2022]
Abstract
Objectives The aim of this prospective, randomized, double-blind, controlled clinical study was to evaluate the analgesic effect of ibuprofen versus diclofenac plus orphenadrine on postoperative pain in orthognathic surgery. Material and methods Patients who underwent orthognathic surgery were randomized into two groups to receive intravenously either 600 mg of ibuprofen (I-group) or 75 mg diclofenac plus 30 mg orphenadrine (D-group), both of which were given twice daily. Additionally, both groups were given metamizole 500 mg. Rescue pain medication consisted of acetaminophen 1000 mg and piritramide 7.5 mg as needed. To assess the pain intensity, the primary end point was the numeric rating scale (NRS) recorded over the course of the hospital stay three times daily for 3 days. Results One hundred nine patients were enrolled (age range, 18 to 61 years) between May 2019 and November 2020. Forty-eight bilateral sagittal split osteotomies (BSSO) and 51 bimaxillary osteotomies (BIMAX) were performed. Surgical subgroup analysis found a significant higher mean NRS (2.73 vs.1.23) in the BIMAX D-group vs. I-group (p = 0.015) on the third postoperative day. Additionally, as the patient’s body mass index (BMI) increased, the mean NRS (r = 0.517, p = 0.001) also increased. No differences were found between age, gender, length of hospital stay, weight, operating times, number of patients with complete pain relief, acetaminophen or piritramide intake, and NRS values. No adverse events were observed. Conclusion The results of this study demonstrate that ibuprofen administration and lower BMI were associated with less pain for patients who underwent bimaxillary osteotomy on the third postoperative day. Therefore, surgeons may prefer ibuprofen for more effective pain relief after orthognathic surgery. Clinical relevance Ibuprofen differs from diclofenac plus orphenadrine in class and is a powerful analgetic after orthognathic surgery.
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Affiliation(s)
- Josip Tomic
- Department of Oral and Maxillofacial Surgery, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria.
| | - Jürgen Wallner
- Department of Oral and Maxillofacial Surgery, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria
| | - Irene Mischak
- Department of Dental Medicine and Oral Health, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria
| | - Gerald Sendlhofer
- Executive Department for Quality and Risk ManagementDivision of Plastic, Aesthetic and Reconstructive SurgeryDepartment of Surgery, Research Unit for Safety in Health, Medical University of Graz, Graz, Austria
| | - Wolfgang Zemann
- Department of Oral and Maxillofacial Surgery, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria
| | - Monika Schanbacher
- Department of Oral and Maxillofacial Surgery, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria
| | - Hamid Hassanzadeh
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Andreas Sandner-Kiesling
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Styria, Austria
| | - Michael Payer
- Department of Dental Medicine and Oral Health, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria
| | - Tomislav A Zrnc
- Department of Oral and Maxillofacial Surgery, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria
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Endoscopic Endonasal Orbital Floor Fracture Repair With Mucosal Preservation to Reinforce the Fractured Bone. J Craniofac Surg 2021; 32:541-545. [PMID: 33704978 DOI: 10.1097/scs.0000000000006849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Treatment of orbital floor fracture is often needed to cure diplopia and enophthalmos. However, the available surgical methods have many limitations. An endoscopic endonasal reduction is a familiar approach for otolaryngologists; however, reconstruction of the orbital floor may pose certain problems. Here, the authors developed the endoscopic endonasal orbital floor fracture repair with mucosal preservation procedure (mucosal preservation procedure). This study aims to evaluate outcomes after the mucosal preservation procedure. The authors analyzed 18 patients who had their orbital floor repaired using the mucosal preservation procedure. Pre- and post-operative ocular motility range was measured with a Hess screen test, and the percentage of Hess area ratio (HAR%) was used for all statistical comparisons. The distance between the fractured bone and orbital floor (DBFO) on computed tomography was measured before and four months after surgery. Overall, diplopia, and pain improved after surgery in all patients. Diplopia and pain completely disappeared in 17 patients, while only mild diplopia remained in one. HAR% increased significantly, whereas DBFO reduced significantly after the operation. In conclusion, the outcome of the mucosal preservation procedure was favorable without any major complications. Further studies with larger numbers of patients are needed to verify our technique.
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Valencia MR, Miyazaki H, Ito M, Nishimura K, Kakizaki H, Takahashi Y. Radiological findings of orbital blowout fractures: a review. Orbit 2021; 40:98-109. [PMID: 32212885 DOI: 10.1080/01676830.2020.1744670] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 03/11/2020] [Indexed: 06/10/2023]
Abstract
Purpose: To summarize the radiological findings in patients with orbital blowout fractures. Methods: We reviewed the published literature on radiological findings of orbital blowout fractures that were searched on PubMed and included our own radiologic findings on patients with orbital blowout fractures that were seen at our hospital. Results: Radiologic examination reveals a variety of findings in each case. However, common radiological findings of orbital blowout fractures include comminuted/unhinged, hinged, and linear fractures. These fractures are usually located in the orbital floor medial to the infraorbital nerve and in the medial orbital wall. Orbital fat is frequently herniated in the paranasal sinus or incarcerated at the fracture site. Orbital emphysema and haematoma sometimes occur as complications. Conclusions: This review will provide surgeons with a better understanding of various radiological findings, which could be helpful in the management of patients with orbital blowout fracture.
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Affiliation(s)
- Ma ReginaPaula Valencia
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital , Aichi, Japan
- Section of Orbital Surgery and Section of Oculoplastic and Lacrimal Surgery, The Medical City Eye and Vision Institute , Metro Manila, Philippines
| | - Hidetaka Miyazaki
- Department of Oral and Maxillofacial Surgery, Graduate School Tokyo Medical and Dental University , Tokyo, Japan
| | - Makoto Ito
- Departments of Radiology, Aichi Medical University , Aichi, Japan
| | | | - Hirohiko Kakizaki
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital , Aichi, Japan
| | - Yasuhiro Takahashi
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital , Aichi, Japan
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