Uses of RTV silicone in orbital reconstruction.

In a five-year follow-up of 42 patients with unsatisfactory cosmetic results after enulceation, room-temperature vulcanizing (RTV) silicone was used in the surgical correction of enophthalmos and superior sulcus depression. RTV silicone with a catalyst was placed in a dissected pocket subperiosteally along the floor and lateral wall of the orbit to correct the volume deficit. When vulcanizing in situ into soft silicone rubber, the implant conformed to the orbital wall and did not migrate. We determined tissue tolerance to in situ vulcanizing silicone histologically in 30 rats by inserting prevulcanized and in situ vulcanized material in paired subcutaneous pockets. No statistical difference was noted between the two methods. In 11 cases, the same material was used as a convenient stent to maintain the pressure over a graft and to maintain socket size after the reconstruction of a contrated socket, by filling the socket with RTV silicone which surrounded a Kirschner wire drilled through the lateral orbital rim.