ArticleBrazilian journal of otorhinolaryngology2026
Double-sheeted silicone plate reconstruction for inferomedial orbital wall fractures: a retrospective single-center case series with a historical reference cohort.
Article in Brazilian journal of otorhinolaryngology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate postoperative enophthalmos and ocular motility following Double Silicone Procedure (DSP), contextualized against an earlier Silicone Balloon Fixation (SBF) cohort from a time-separated single-center experience.
methodsWe conducted a single-center retrospective case series (April 2000 - December 2024) across a technique transition (SBF before April 2014; DSP thereafter). Primary outcomes were patient-reported enophthalmos (graded 0-4) and postoperative ocular motility (HAR%). Between-era differences were descriptively analyzed using Hodges-Lehmann estimates with 95% Confidence Intervals (95% CIs).
resultsThirty patients met the inclusion criteria (DSP, n = 10; SBF, n = 20). The median postoperative enophthalmos score was 0 (Interquartile Range [IQR] 0-0) in the DSP group (n = 10) and 1 (IQR 0-1) in the SBF group (n = 13) (Hodges-Lehmann Δ = -1.0; 95% CI -1.0 to 0.0; p = 0.008). Among DSP patients with postoperative Hertel exophthalmometry measurements (n = 8), no patient exhibited clinically perceptible enophthalmos (>2 mm); the median Hertel exophthalmometry difference was -1.0 mm (IQR -1.0 to 0.0). Postoperative HAR% was 92.1% (IQR 86.0-100.0) after DSP and 88.4% (IQR 80.4-97.0) after SBF (p = 0.397). No optic nerve injuries, infections, or implant-related complications were observed in either group.
conclusionIn this single-center experience across a surgical technique transition, DSP demonstrated favorable postoperative outcomes, with reduced enophthalmos and preserved ocular motility. Although earlier cases served as a historical reference, these exploratory findings support DSP as a safe and practical option for complex inferomedial orbital wall fractures. LEVEL OF EVIDENCE: 4:
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