Personalized reconstruction of orbital defect based on the precise three-dimension orientation and measurement of eye socket

Abstract

Abstract: PURPOSE: To evaluated the methods for precise assessment of severity of traumatic orbital defect and techniques for customized reconstruction of orbital defect. METHODS: A retrospective study was conducted on 97 patients with traumatic orbital defect treated in our hospital from Jul. 2003 to Jun. 2012. Pre- and postoperative spiral computed tomography scans were available in all cases. Surgeons adapted a spatial location technique to measure the 3-dimensional position of the eyeball, followed by calculating the variation of orbital volume. Then the orbital model was fabricated utilizing computer-assisted design/manufacture and rapid prototyping technique to aid surgical planning and prefabricate implants and bone bonding plates. During surgery, surgeons fully exposed the orbital defect, then repositioned the herniated orbital contents and placed the prefabricated titanium mesh, Medpor or other implants to restore orbital morphology in the defect site and regain normal proportion between orbital walls and contents. The treatment outcome was evaluated in terms of postoperative appearance, patients’ satisfaction, ophthalmologic examination and CT scans and untoward complications were analyzed postoperatively. RESULTS: Except unsatisfactory aesthetic result in 1 case, residual enophthalmos and diplopia with no significant improvement 6 months after surgery in 2 cases resulting from long-standing trauma, mild postoperative lower eyelid ectropion in 2 cases, the remaining patients were satisfactory with the results both in orbital morphology and proportion between orbital walls and contents with no overt complications. CONCLUSIONS: With the advantage of accurate digital evaluation on 3-dimensional position of the eyeballs and variation of orbital volume and customized modeling surgery, surgeons are capable of simulating surgery and carrying out early operation to minimize trauma and maintain or correct the position of eyeballs as well as reconstruct orbital defect anatomically so that customized reconstruction of orbital defect is achieved and efficacy thereof is guaranteed.

Key words: Personalization, Orbit fracture, Reconstruction, Rapid prototyping

CLC Number:

R782.4

HUANG Li, LIN Li-song, WANG Zhi-hong, SHI Bin, ZHU Xiao-feng, QIU Yu, HUANG Yue, YU Xue-yuan, LIAO Yun-yang. Personalized reconstruction of orbital defect based on the precise three-dimension orientation and measurement of eye socket[J]. China Journal of Oral and Maxillofacial Surgery, 2014, 12(2): 136-143.

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