ACKNOWLGEMENT

ACKNOWLEDGEMENT

I first and foremost thank “Almighty God”, whose blessing make things possible.

It’s a great pleasure to express my heartfelt thanks and gratitude to my post-graduate teacher
Dr. Channaveer Pattanshetti, Professor, Department of Oral and Maxillofacial Surgery for
guidance, valuable suggestions and inspirations not only in the studies but in my life as well.
I feel very blessed and privileged to learn under him. This study would not have been
possible without his support.

I am thankful to Dr. Sakshi Patil, Associate Professor, Department of Ophthalmology for

providing her valuable time and sharing her knowledge with me.

I take this opportunity to express my humble gratitude to Dr. Sanjay Byakodi, Professor and
Head, Department of Oral and Maxillofacial Surgery and Dr. Amit Basannavar, Associate
professor, Department of Oral and Maxillofacial Surgery for support given to me during the
tenure of this work. I thank all the Staff Members of Department of Oral and Maxillofacial
Surgery for their motivation and support.

It is impossible to extend enough thanks to my parents, Sanjay Gunjal and Alka Gunjal
who have devoted their entire life for my success. My brother Harshal and Sujit who have
been constant support to me.

I would like to thank my dear friend Dr. Kavita Sharma and colleague Dr. Aprajeeta
Kaushik for being a strong support in this study as well as my post-graduation study.

I am grateful to my seniors Dr. Harshwardhan Kadam, Dr. Naziya Nadaf and Dr. Rozina
Vishnani for encouragement and guidance and my dear juniors Dr. Darshan Wable, Dr.
 ACKNOWLGEMENT

Premlesh Kumar Pal, Dr. Yashasvi Kanoria, Dr. Jestina and Dr. Kishan Dudhat for
their help and co-operation.

I would like to thank all the non-teaching staff for their services and help they delivered

whenever required.

This work is dedicated to them.

- Dr. Vishakha Gunjal

 -

Dedicated to my
parents who have
devoted their
entire life for my
success
 ABBREVIATIONS

ABBREVIATIONS

FIG Figure
CT Computed Tomography
3D CT Three-Dimensional Computed Tomography
BSV Binocular single vision
MRI Magnetic resonance imaging
PFTi Preformed titanium orbital plate implant
PPETi Porous polyethylene or titanium hybrid implant
RTA Road Traffic Accident
EN Enopthalmos
DP Diplopia
FF Orbital floor fracture;
L Left,
R Right
BL Bilateral
EDH Extradural hematoma
ZMC Zycomaticocomplex
# Fracture
SAH Subarachnoid hematoma
ION Inferior alveolar nerve;
SH Subconjunctival hemorrhage
HDPE High density porous polyethylene
 TABLE OF CONTENT

TABLE OF CONTENT

SR. NO CONTENT PAGE NO.

1 INTRODUCTION 1

2 AIM AND OBJECTIVES 6

3 REVIEW OF LITERATURE 8

4 MATERIAL AND METHODOLOGY 13

5 OBSERVATIONS AND RESULTS 36

6 DISCUSSION 60

7 SUMMARY AND CONCLUSION 63

8 BIBLIOGRAPHY 65

9 ANNEXURE 68
 LIST OF FIGURES

LIST OF FIGURES

FIG. NO. FIGURES PG. NO.

1. Porous Polyethylene Medpor 18
2. Titanium mesh implant 18
3. Surgical armamentarium 18
4. Study group - Preoperative profile view 24
5. Study group - Preoperative radiographs- 3D CT FACE and 24
coronal section
6. Study group - Incision marking 25
7. Study group - Exposure of orbital defect 25
8. Study group - Reconstruction of defect site using titanium 26
mesh
9. Study group – Closure 26
10. Study group – 1st Follow up postoperative profile immediately 27
after surgery.
11. Study group- Postoperative PNS 27
12. Study group – 1st month follow up profile after surgery 28
13. Study group – 1st month postoperative 3D CT Face 28
14. Study group- 3rd month follow up profile after surgery. 29
15. Study group – 3rd month postoperative 3D CT Face 29
16. Control group - Preoperative profile view 30
17. Control group - Preoperative radiographs- 3D CT FACE and 30
coronal section
18. Control group - Incision marking 31
19. Control group - Exposure of orbital defect 31
20. Control group - Reconstruction of defect site using titanium 32
mesh
 LIST OF FIGURES

21. Control group – Closure 32

22. Control group – 1st Follow up postoperative profile 33
immediately after surgery.
23. Control group- Postoperative PNS 33
24. Control group – 1st month follow up profile after surgery 34
25. Control group – 1st month postoperative 3D CT Face 34
26. Control group- 3rd month follow up profile after surgery. 35
27. Control group – 3rd month postoperative 3D CT Face 35
 LIST OF TABLES

LIST OF TABLES

TABLE 1 Diagnosis of patients included in Group A (study group).

TABLE 2 Diagnosis of patients included in Group B (control group).

TABLE 3 Age distribution

TABLE 4 Gender distribution
TABLE 5 Preoperative swelling assessment
TABLE 6 Swelling assessment 1st week postoperatively.
TABLE 7 Swelling assessment 1st Month postoperatively.
TABLE 8 Swelling assessment 3rd month postoperatively
TABLE 9 Preoperative pain assessment
TABLE 10 Pain assessment 1st week postoperatively
TABLE 11 Pain assessment 1st month postoperatively
TABLE 12 Pain assessment 3rd month postoperatively
TABLE 13 Preoperative assessment of infraorbital nerve paresthesia
TABLE 14 Inferior orbital nerve paresthesia 1st week postoperatively.
TABLE 15 Inferior orbital nerve paresthesia 1st month postoperatively
TABLE 16 Inferior orbital nerve paresthesia 3rd month postoperatively
TABLE 17 Preoperative Subconjunctival hemorrhage assessment
TABLE 18 Subconjunctival hemorrhage 1st week postoperatively
TABLE 19 Subconjunctival hemorrhage 1st month postoperatively
TABLE 20 Subconjunctival hemorrhage 3rd month postoperatively
TABLE 21 Preoperative ocular motility assessment
TABLE 22 Ocular motility – Diplopia 1st week postoperatively
TABLE 23 Ocular motility – Diplopia 1st month postoperatively
TABLE 24 Ocular motility – Diplopia 3rd month postoperatively