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Neuroradiology Case of the Week

Case 308

Malin Cesarz, MD and P-L Westesson, MD, PhD, DDS

Clinical Presentation: A 44-year-old male presents status assault.

Imaging Findings:

Figure 1: Left orbital floor fracture with displacement of the orbital floor fracture fragment into the left maxillary sinus. Fluid in the left maxillary sinus.
Figure 2: Reconstruction of the floor of the left orbit with mesh. Mucosal thickening of bilateral maxillary sinuses.

Diagnosis: Orbital floor reconstruction with mesh

Discussion: Previously autologous bone or cartilage and wires, metal plates, and screws were the standard for bony repair. More recent implant technology, including those employing porous polyethylene, has resulted in improved biocompatibility. The porous structure allows the quick ingrowth of vascular structures, soft tissues, and bone.
     This particular example is a titanium and porous polyethylene implant made by Synthes.

References:

  1. Cummings CW. Otolaryngology: Head & Neck Surgery, 4th ed. Mosby, 2005.
  2. Villarreal PM, Monje F, Morillo AJ, Junquera LM, González C, Barbón JJ. Porous polyethylene implants in orbital floor reconstruction. Plast Reconstr Surg. 2002 Mar;109(3):877-85; discussion 886-7. [Medline]
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