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

Summary 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.