Titanium micromesh in orbit reconstruction

Orbits can be affected by a number of conditions such as facial injuries, benign and malignant tumors and malformations. The damage they cause varies from simple discontinuities in the orbital floor to gaps with severe loss of tissue. In this latter case, orbital walls must be reconstructed. To this purpose, several homologous and autologous materials have been suggested, all being excellent in terms of biocompatibility and bearing very little risk of infection and host vs. graft reaction. Among alloplastic materials, titanium micromesh is of special importance as it can be easily moulded, it is strong and biocompatible. The authors report their experience in the Maxillo-Facial Dept. of 'La Sapienza' University in Rome between 1992 and May 1995. They have treated 42 patients requiring reconstruction of the orbital walls with titanium mesh. Of these patients 19 were female and 23 male, aged between 20 and 60 yrs. Most cases were due to injury or were injury sequelae. Post-operative results were good with complete resolution of symptoms and good cosmetic and functional recovery in 70% of cases. Four patients complained of moderate post-operative dyplopia and in three cases the pupils were also not levelled. Considering the excellent results, the authors believe that titanium micromesh can be used to repair large losses of tissue in the orbital walls: orbital anatomy and function are restored with few post-operative complications.