Technical Note on Three- and Four-Wall Orbital Reconstructions With Patient-Specific Implants

Sabelis, Juliana F.; Youssef, Stephen A L Y; Hoefnagels, F.W.A.; Becking, A.G.; Schreurs, Ruud; Dubois, L.

doi:10.1097/scs.0000000000008303

Cited by 5 publications

(8 citation statements)

References 30 publications

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“…PSIs may also be used to create an artificial orbital rim and floor for globe support after maxillectomy [84,85]. The most extensive orbital PSI reconstructions have been described after the resection of a spheno-orbital meningioma or neurofibroma [55,86]. In these cases, the reconstruction of all four orbital walls with multiple PSIs enabled a predictable reconstruction of the internal orbit in the same surgical setting as the resection.…”

Section: Discussionmentioning

confidence: 99%

“…This enables a reconstruction that covers the entire defect while limiting the size of the PSI and, in turn, the required The PSI design can be adapted to facilitate the reconstruction of multi-wall defects, for example, through the application of multiple PSIs (Figure 6). This enables a reconstruction that covers the entire defect while limiting the size of the PSI and, in turn, the required incision [46,55]. Depending on the connection used, it also provides the opportunity to create artificial support and relative feedback.…”

Section: Patient-specific Implant Designmentioning

confidence: 99%

“…incision [46,55]. Depending on the connection used, it also provides the opportunity to create artificial support and relative feedback.…”

Section: Patient-specific Implant Designmentioning

confidence: 99%

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3D Innovations in Personalized Surgery

2023

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Section: Discussionmentioning

confidence: 99%

Section: Patient-specific Implant Designmentioning

confidence: 99%

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3D Innovations in Personalized Surgery

2023

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“…Recently, Sabelis et al . [ 13 ] described the use of PSI for total reconstruction in a case of spheno-orbital meningioma resection sequelae. Ruiters and Mombaerts reviewed the applications of 3D printing technology for orbital defect reconstructions.…”

Section: Discussionmentioning

confidence: 99%

Late patient-fitted total orbital reconstruction for facial gunshot wound sequelae

Lima

Pinto²,

Pinheiro

et al. 2023

National Journal of Maxillofacial Surgery

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Late reconstructions of gunshot wounds (GSWs) in the orbital area are a true challenge to the oral and maxillofacial surgeon. Usually, the wall defects are large in size and commonly present loss of orbital volume, which can cause ocular dystopia. The only exceptions are when there is an explosion of the orbital walls—that is, blow-out fractures. We encountered a patient with a two-year sequelae after GSW in the face that caused the destructed orbit to have a 2.5 bigger size than the contralateral orbit, requiring meticulous planning of a patient-specific implant (PSI) to correctly reconstruct the orbit volume and bone projection. The PSI was developed using titanium and it had three pieces that could reconstruct all four walls of the orbit. After surgery, the patient regained orbital volume and malar projection, allowing him to benefit from facial symmetry. The PSI can be used to reconstruct all the orbital walls in cases of complex bone defects.

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“…This overview is not comprehensive, and novel design options are regularly introduced in the literature. Posterior to bulbus [49] Orbital floor elevated in sagittal relation Amount [22] Based on clinical findings, advanced diagnostics [38] Slight overcorrection [50] Eccentric screw alters implant position [47] Fix implant if form stable [40] Fixation re-use Accuracy Re-used screw hole [54] Only in secondary reconstruction Multi-piece Positioning, stability, Lazy-S [42,47,49] accuracy Interlocking [46,48,55,56] Design considerations can be categorized based on their intended effect: stability, positioning ease, accuracy of implant positioning or alleviation of clinical symptoms. The size and shape of the implant are dependent on the extent of the defect.…”

Section: Patient-specific Implant Designmentioning

confidence: 99%

Personalized Medicine Workflow in Post-Traumatic Orbital Reconstruction

Sabelis

Schreurs

Essig

et al. 2022

JPM

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Restoration of the orbit is the first and most predictable step in the surgical treatment of orbital fractures. Orbital reconstruction is keyhole surgery performed in a confined space. A technology-supported workflow called computer-assisted surgery (CAS) has become the standard for complex orbital traumatology in many hospitals. CAS technology has catalyzed the incorporation of personalized medicine in orbital reconstruction. The complete workflow consists of diagnostics, planning, surgery and evaluation. Advanced diagnostics and virtual surgical planning are techniques utilized in the preoperative phase to optimally prepare for surgery and adapt the treatment to the patient. Further personalization of the treatment is possible if reconstruction is performed with a patient-specific implant and several design options are available to tailor the implant to individual needs. Intraoperatively, visual appraisal is used to assess the obtained implant position. Surgical navigation, intraoperative imaging, and specific PSI design options are able to enhance feedback in the CAS workflow. Evaluation of the surgical result can be performed both qualitatively and quantitatively. Throughout the entire workflow, the concepts of CAS and personalized medicine are intertwined. A combination of the techniques may be applied in order to achieve the most optimal clinical outcome. The goal of this article is to provide a complete overview of the workflow for post-traumatic orbital reconstruction, with an in-depth description of the available personalization and CAS options.

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Technical Note on Three- and Four-Wall Orbital Reconstructions With Patient-Specific Implants

Cited by 5 publications

References 30 publications

3D Innovations in Personalized Surgery

3D Innovations in Personalized Surgery

Late patient-fitted total orbital reconstruction for facial gunshot wound sequelae

Personalized Medicine Workflow in Post-Traumatic Orbital Reconstruction

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