Efficacy of Titanium Mesh in Correcting Orbital Volume and Enophthalmos in Impure Orbital Blow-Out Fractures

Abstract

Background: Orbital blow-out fractures, particularly those involving the zygomaticomaxillary complex, can result in significant functional and aesthetic complications such as enophthalmos due to increased orbital volume. Objective: To evaluate the efficacy of titanium mesh in correcting orbital volume and enophthalmos in patients with impure orbital blow-out fractures using pre- and postoperative computed tomography (CT) measurements. Methods: This was a cross-sectional observational study conducted at the Oral and Maxillofacial Surgery Department, PMC Dental Institute, Faisalabad Medical University, from January to July 2021. A total of 75 patients aged 18–50 years with isolated impure orbital blow-out fractures and CT-confirmed enophthalmos were enrolled. Patients with pure orbital fractures, panfacial trauma, or contraindications to CT were excluded. All participants underwent open reduction and internal fixation of zygomaticomaxillary fractures with orbital floor reconstruction using 0.3 mm titanium mesh. Pre- and postoperative enophthalmos and orbital volume were assessed via CT imaging. Ethical approval was granted by the Institutional Review Board, and all procedures adhered to the Helsinki Declaration. Data was analyzed using SPSS v27 with paired t-tests and chi-square tests, considering p ≤ 0.05 statistically significant. Results: The mean preoperative enophthalmos was 3.38 ± 0.48 mm, which reduced significantly to 0.73 ± 0.51 mm postoperatively (p < 0.001). Orbital volume discrepancies showed corresponding reduction, and clinical efficacy of titanium mesh was observed in 89.3% of cases. Minor complications occurred in 10.7% of patients, primarily related to mesh malposition or exposure. Conclusion: Titanium mesh is a clinically effective and reliable material for restoring orbital volume and correcting enophthalmos in impure orbital blow-out fractures. Its biocompatibility, ease of handling, and low complication rate make it a valuable reconstructive option in maxillofacial trauma surgery.