Application of Rapid Prototyping Technique and Intraoperative Navigation System for the Repair and Reconstruction of Orbital Wall Fractures

Abstract

BackgroundRestoring the orbital cavity in large blow out fractures is a challenge for surgeons due to the anatomical complexity. This study evaluated the clinical outcomes and orbital volume after orbital wall fracture repair using a rapid prototyping (RP) technique and intraoperative navigation system.MethodsThis prospective study was conducted on the medical records and radiology records of 12 patients who had undergone a unilateral blow out fracture reconstruction using a RP technique and an intraoperative navigation system from November 2014 to March 2015. The surgical results were assessed by an ophthalmic examination and a comparison of the preoperative and postoperative orbital volume ratio (OVR) values.ResultsAll patients had a successful treatment outcome without complications. Volumetric analysis revealed a significant decrease in the mean OVR from 1.0952±0.0662 (ranging from 0.9917 to 1.2509) preoperatively to 0.9942±0.0427 (ranging from 0.9394 to 1.0680) postoperatively.ConclusionThe application of a RP technique for the repair of orbital wall fractures is a useful tool that may help improve the clinical outcomes by understanding the individual anatomy, determining the operability, and restoring the orbital cavity volume through optimal implant positioning along with an intraoperative navigation system.

Three-Dimensional diagnosis in orbital reconstructive surgery

“…These implants usually include bone, cartilage, titanium, and resorbable mesh. [ 9 ] The surgical outcomes depend on two basic factors: (1) identity of the shape of orbital implant to anatomy of orbit that should be reconstructed and (2) accuracy of positioning of orbital implant related to adjacent anatomical structures. First factor can be achieved by implementation of different technologies, such as preformed orbital plates (MatrixORBITAL™ MatrixMIDFACE, DePuySynthes), rapid prototyping (RP) and fabrication of patient-specific plastic models of the skull, and customized orbital implant fabrication as well.…”

“…[ 1 ] It is usually achieved by transconjunctival, subciliary, and coronal approaches and implementation of graft and reconstructive materials, including bones, cartilage, titanium, and resorbable mesh. [ 8 9 ]…”

“…Recent advances in computer technology allows the operator to manipulate CT scan data and produce patient-specific virtual planning as well as plastic models and customized implant materials. [ 9 ]…”

Assessment of oral health-related quality of life for complex mandibular defects rehabilitated with computer-guided implant restoration

“…With the CBCT, the anatomical structures which are close to the site such as teeth, sinus, nerves, and arteries can be assessed accurately and planned, and even the best soft-tissue thickness can be measured and planned accordingly with Simplant guide. [ 22 ] The treatment plan with Simplant indirectly helps in the OHRQoL of the patients because it simplifies the procedure, thereby minimizing the complications and surgical abuse.…”

A retrospective study to compare the treatment outcomes with and without surgical navigation for fracture of the orbital wall

“…The prevalence of OWF has been reported to be 18%–50% in all cases of craniomaxillofacial trauma. 1 , 2 , 3 Safe, rapid and precise reconstruction of the orbital wall is essential for restoring normal function and esthetics, but repair is hampered due to limited surgical exposure and complicated three-dimensional (3D) anatomic structures. Also, the reconstruction outcome is unpredictable because of soft-tissue edema, broken contours of the orbital wall, and difficulty of positioning the implant appropriately.…”