The use of detachable flanges on customized titanium orbital implants: a technical note.

The combined use of three-dimensional reformatted images, stereolithographic models, and rapid prototyping allows the construction of an accurate, individually made titanium implant for the reconstruction of orbital floor defects. Despite the perfect fit of the custom-made plate to the model, there might be several locations on the bone where the plate may reside intraoperatively. Most titanium orbital plates therefore contain extensions over the inferior orbital rim to help locate and stabilize the plate in its position on the bone. Such over-the-rim extensions may be palpable and can cause discomfort postoperatively. We describe the use of two small detachable flanges that help to accurately locate the orbital plate in place and allow its fixation. The locating flanges are then detached and discarded, leaving a smooth implant surface within the confines of the bony orbit.