AB193. SOH24AB_176. A retrospective analysis of orbital floor reconstruction at University Hospital Limerick over last 2 years

Background: A high instance of orbital floor fractures (OFFs) is observed in the Oral and Maxillofacial Department, University Hospital Limerick (UHL). Typical diagnosis is by clinical and radiographic examination using computed tomography (CT). Many recent studies have looked at varying approaches for orbital floor reconstruction (OFR). The aim of this case series is to analyse the demographics, aetiology and management of patients who underwent OFR.

Methods: A two-year retrospective case series was completed examining charts of patients who underwent reconstruction of orbital floor defects at UHL.

Results: The factors that had the greatest influence on surgical decision making were defects causing persistent diplopia, globe malposition or entrapment. The study included 22 patients who underwent OFR. Radiographic pre-operative assessment using CT scans was completed for 91% of patients, of which 6% had CT orbit, 86% had CT facial bones and 36% had both CT facial bones and CT brain. 50% of patients were treated with the transconjunctival approach and 50% with the sub-tarsal transcutaneous approach. Reconstruction techniques included the use of titanium mesh (45%), Stryker^® pre-formed anatomic plates (50%) and 5% polydioxanone sheet (PDS).

Conclusions: Both treatment approaches and materials used are viable and operator specific. Both have complications but similar outcomes based on post-operative review. The pre-operative use of CT facial bones should be included as a clinical standard prior to OFR. A clear need exists for improvement in data analysis to guide and set standards of care for the specialties managing OFR.

Keywords: Orbital floor reconstruction (OFR); Stryker pre formed plates; sub tarsal; titanium mesh plate; transconjunctival