Meta-analysis of orbitozygomatic complex trauma. The cost–benefit relationship for the usefulness of eye care and orthoptic screening

Abstract

Background and Objective: Orbital blow-out fractures are commonly a result of motor vehicle accidents, interpersonal violence, or sports injuries and often require reconstructive surgery. A plethora of different surgical approaches are currently used in orbital floor reduction. These include transconjunctival, subciliary, mid-lower eyelid, infraorbital and, more recently, endoscopic transantral approaches. Some of the aforementioned treatment strategies are combined with additional measures like intraoperative imaging or navigation to enhance the accuracy hence surgical outcome. The current treatment method at the VU University Medical Center consists of a combination of virtual preoperative planning and three-dimensional (3D) printing. This novel approach has resulted in very good "subjective" clinical outcomes. However, an "objective" method of assessing the outcome of orbital reconstructions after trauma is still sought. Methods: To date, 15 patients have been operated using the aforementioned method. In order to assess the overall accuracy and the outcome of the orbital floor operation, virtually planned STL models were compared with the postoperative STL models of three patients. This presentation will describe all steps required to objectively assess the outcome of orbital reconstruction after trauma. Findings: The proposed 3D method demonstrated a strong agreement between the virtually planned and the resulting orbital floor reduction. This novel strategy offers a possible alternative to intraoperative CT and navigation in the treatment of orbital floor patients. Conclusions: Pre-and postoperative STL models can be used to evaluate the accuracy of orbital floor reconstructions after trauma. http://dx.