Computer‐assisted therapy in orbital and mid‐facial reconstructions

Schramm, Alexander; Suárez‐Cunqueiro, María Mercedes; Rücker, Martin; Kokemueller, Horst; Bormann, Kai-Hendrik; Metzger, Marc Christian; Gellrich, Nils‐Claudius

doi:10.1002/rcs.245

Cited by 105 publications

(59 citation statements)

References 41 publications

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“…[5][6] . Beumer, Pham and Schramm [18][19][20] recommend the use of CT navigation in maxillofacial bone fractures to minimize post-traumatic enophthalmos and for improved facial symmetry.…”

Section: Discussionmentioning

confidence: 99%

Indications for repositioning of blow-out fractures of the orbital floor based on new objective criteria - tissue protrusion volumometry

Kovář¹,

Voldrich²,

Voska³

et al. 2017

BIOMED PAP

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a Background and Aim. The otolaryngologist often meets with fractures of the orbital floor. The most serious complication is diplopia, arising as a result of herniation of the orbital contents, with or without fixation of the inferior rectus muscle. The aim of our work was to create a mathematical model to calculate the volume of prolapsed soft tissue of the orbit in blow-out fractures, as a factor in deciding on the need for surgical treatment. Patients and Methods. In a retrospective study (2007)(2008)(2009)(2010)(2011)(2012)(2013), we evaluated 80 patients with blow-out fractures, divided into two equal groups: 40 conservatively treated and 40 surgically treated patients. We created the model by measuring the fracture lines and herniation of the orbital soft tissues in the coronal and sagittal sections from CT images, equivalent to half the volume of a rotating ellipsoid. Results. According to the proposed model, posterior and anterior fractures with a prolapse volume above 500 mm 3 , and anteroposterior fractures with a volume over 1400 mm 3 , are indicated for surgery. Conclusion. The volume of prolapsed soft tissue relative to the location of the fracture is the main indicator for selecting the best treatment procedure immediately after injury.

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“…[5][6] . Beumer, Pham and Schramm [18][19][20] recommend the use of CT navigation in maxillofacial bone fractures to minimize post-traumatic enophthalmos and for improved facial symmetry.…”

Section: Discussionmentioning

confidence: 99%

Indications for repositioning of blow-out fractures of the orbital floor based on new objective criteria - tissue protrusion volumometry

Kovář¹,

Voldrich²,

Voska³

et al. 2017

BIOMED PAP

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“…Concerning the management of midfacial bilateral fractures, Schramm et al recently described a new technical approach for pure bilateral orbital floor fractures [19]. They first carried out the usual pre-operative planning by correctly mirroring the non-fractured orbital frame.…”

Section: Discussionmentioning

confidence: 99%

Image guided surgical navigation integrating “mirroring” computational planning based on intra-operative cone-beam CT imaging: A promising new approach for management of primary bilateral midfacial fractures

Terzic

Scolozzi

2011

Computer Aided Surgery

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Cosmetic and functional re-establishment following primary or secondary treatment of comminuted and complex midfacial fractures remains a challenge for surgeons. Computer Assisted Surgery (CAS) has revolutionized the conceptualization and approach to these reconstructions and has become a reliable part of the surgical armamentarium. Computer aided design/ modeling (CAD/CAM) software that allows ''mirroring'' planning coupled to navigation systems has dramatically improved surgical strategies in reconstructive surgery of the craniomaxillofacial skeleton, particularly with respect to the prediction of suitable symmetric bone repositioning. So far, however, use of this approach has been limited to unilateral cases, with a non-fractured contralateral side being considered the condition sine qua non for the application of such a technique and the ''mirroring'' planning being performed on pre-operative CT imaging.We report a case of complex primary reconstruction in a patient presenting with bilateral midfacial fractures, using complete intra-operative sequence processing with a navigation system integrating ''mirroring'' computational planning based on a mobile C-arm cone-beam computed tomography (CBCT) scan with a flat-panel detector. To the best of our knowledge, no similar cases have yet been reported involving the use of this sequencing method in the primary management of bilateral midfacial fracture reconstruction.

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“…Im Folgenden sind typische klinische Beispiele der Anwendung der computerassistierten Chirurgie dargestellt, wie sie bereits in der klinischen Routineversorgung zum Einsatz kommen [1,2,4,9,10,14,16,21,22,23,24,25,27]. Bei der operativen Reposition und Osteosynthese von Frakturen des Gesichtsschädels kann aufgrund der nur kurzen Datensatzerhebungszeit (5-10 min) eine intraoperative Bildgebung mit einem 3-D-C-Bogen (intraoperative Volumentomographie) zur Stellungskontrolle vor Wundverschluss auch in der klinischen Routine erfolgen; im Beispiel von .…”

Section: Primärrekonstruktionen Des Gesichtsschädelsunclassified

Die computergestützte Gesichtsschädelrekonstruktion

Schramm

Wilde

2011

HNO

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Injury to the facial skeleton may result not only in aesthetic but also functional deficits. Computer-assisted surgery promises predictable reconstructive results. In clinical routine the authors use the combination of preoperative planning, intraoperative navigation and intraoperative imaging to treat complex facial trauma. With preoperative planning the intended reconstructive results can be precisely preplanned and guided intraoperatively using navigational surgery. Intraoperative imaging achieves the final intraoperative validation. Using computer-assisted surgery dislocation and malformation of fragments and transplants can be avoided in facial reconstruction. This means reliable quality control of surgical outcome and the number of further surgeries can be reduced in this complex reconstructive surgery.

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Computer‐assisted therapy in orbital and mid‐facial reconstructions

Cited by 105 publications

References 41 publications

Indications for repositioning of blow-out fractures of the orbital floor based on new objective criteria - tissue protrusion volumometry

Indications for repositioning of blow-out fractures of the orbital floor based on new objective criteria - tissue protrusion volumometry

Image guided surgical navigation integrating “mirroring” computational planning based on intra-operative cone-beam CT imaging: A promising new approach for management of primary bilateral midfacial fractures

Die computergestützte Gesichtsschädelrekonstruktion

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