An innovative technique in orbital floor reconstruction avoiding complications: Temporary use of the silicone guide

Background: Orbital blowout fracture is a relatively common but challenging entity in the field of traumatology. Serious sequels may occur as a consequence of poor visualization or an inappropriate operative maneuver. We herein propose a modified technique featuring routine use of orbitotomy with temporary placement of a silicone shell as the guide template and soft-tissue barricade, thereby facilitating the mesh plate fashioning and expediting the implantation process. Methods: Eleven patients underwent orbital floor open reconstruction with titanium orbital mesh plate implantation between January 2010 and December 2011. After thorough release of the herniated contents from entanglement, we tailored a silicone guide according to the size and shape of the defect and inserted it into the orbital cavity to hold up the soft-tissue contents. Another copy of silicone shell with exactly the same configuration was produced and taken as a reference to formulate the titanium plate. We removed this holding silicone guide after the placement of the orbital plate, avoiding incarceration between the plate and the herniated contents. Results: Follow-up computed tomography scans 3 months after surgery demonstrated adequate reduction of the herniated contents. The patients were spared from complications such as diplopia or enophthalmos. Conclusion: This innovative technique helps to simplify the operation, avoids complications, and is easily practicable.