A New Orbito-Zygomatic Complex Reconstruction Technique Using Computer-Aided Design and Manufacturing–Assisted Harvest of Autologous Calvarial Bone in Cases of Orbito-Zygomatic Benign Tumor

Overview of tools for the measurement of the orbital volume and their applications to orbital surgery

“…If the reconstruction is extended to the zygomatic complex, the surgical challenge increases. 44 Orbital volumetry is indeed necessary to confirm postoperative success. Rana et al in 2015, compared OV of 34 cases of primary reconstruction of unilateral orbital fractures treated using selective laser-melted patient-specific implant or pre-bent titanium mesh.…”

Application of patient-specific implants as alternative approach to zygoma defect management - A retrospective study

“…[ 1 2 5 11 ] A 3D reconstruction of the zygoma is one of the most challenging procedures in craniofacial surgery due to its complex anatomy with a unique combination of concave and convex surfaces; low osteogenic capacity; and proximity to the maxillary sinus, eye globe, orbit, and cranial base. [ 3 4 13 18 21 ]…”

“…[ 5 10 ] Further modifications of this strategy aimed at replacing the convexity of the zygomatic body with the convex surface of the iliac crest or calvarial bone grafts were not precise and were time-consuming due to the necessity of adapting the graft shape to a complex defect configuration. [ 3 4 25 ] In addition, insufficient blood supply of the donor site or compromised recipient vessels were the main contraindications for free tissue transferring. [ 5 26 ] Nevertheless, many authors advocated the use of bone grafting procedures for zygoma reconstruction due to the possible disadvantages of implant application, including foreign body reaction, infection risk, possibility of exposure, high cost, and complexity of the prebending procedure.…”

“…Zygoma defects occur after tumour ablation surgery, trauma management, or congenital anomalies, and frequently lead to alteration of facial harmony, horizontal asymmetry of the face, and significant functional deficit. [ 1 2 3 4 ] Different approaches to zygoma reconstruction have been described in the literature. [ 5 6 ] They include nonvascularized autologous bone grafting, free tissue transfer on microvascular anastomosis, preformed titanium plates and meshes, custom-made patient-specific implants (PSIs), or a combination of the above methods.…”

“…[ 1 7 8 9 ] In recent decades, the autologous bone grafting procedures have been considered the gold standard for reconstruction of midface bone defects. [ 4 10 11 ] Several donor sites are available for bone graft harvesting for zygoma reconstructions, such as iliac crest, fibula, and scapula. [ 3 9 11 ] However, this approach has some significant disadvantages, including the inability to restore the true-to-original anatomy of the zygomatic complex, unpredictable volume loss due to graft resorption during the postoperative period, possible delayed bone healing with an incomplete integration of the bone graft, and morbidity of the donor site.…”