What is the incidence of implant malpositioning and revision surgeries in orbital repair?

Publication date: Available online 23 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Schlittler Fabian, Schmidli Andre, Wagner Franca, Michel Chantal, Mottini Matthias, Lieger Olivier
PurposePostoperative radiographic exams 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.MethodsThis retrospective cohort study was conducted in a Level I trauma center at the University Hospital of Bern, Switzerland. In order to assess the incidence of malpositioning, a qualitative analysis of postoperative CT scans as well as comparative volumetric measurements of the orbits were conducted. Furthermore, the incidence and reason for secondary revision procedures were evaluated.ResultsFrom September 2008 to December 2015, a total of 71 emergency patients (73 implants) were treated at the Department of Cranio-Maxillofacial Surgery using a titanium mesh (49 male, mean age 56). The implant position was rated as poor in 17 cases (23%), using the qualitative analysis. The volumetric assessment showed no significant results. 12 patients (17%) needed revision intervention due to an unsuccessful treatment outcome causing relevant clinical symptoms.ConclusionPatients with large orbital defects, who require surgical treatment with a titanium mesh, are at risk for implant malposition. Since in this study, a poor position of the implant is the main reason for a surgical revision, we postulate, that a postoperative radiographic control should be done routinely. Only then, long-term sequelae due to inadequate reconstruction can be avoided.



http://ift.tt/2woPzOJ