Anatomical 3-dimensional Pre-bent Titanium Implant for Orbital Floor Fractures

Metzger, Marc Christian; Schön, Ralf; Weyer, N.; Rafii, Amir; Gellrich, N.‐C.; Schmelzeisen, Rainer; Strong, E. Bradley

doi:10.1016/j.ophtha.2006.03.062

Cited by 108 publications

(67 citation statements)

References 39 publications

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“…[37][38][39][40][41][42][43] The computer-aided surgery (CAS) navigation system can further improve the outcome of surgical intervention. In traditional maxillofacial surgery, due to the limited exposure of surgical site, the surgeons cannot see directly the operative site and assess immediately whether proper bony reduction is achieved during operation.…”

Section: Computer Applicationsmentioning

confidence: 99%

The management of naso-orbital-ethmoid (NOE) fractures

Wei

Tang

Liu

et al. 2015

Chinese Journal of Traumatology

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The bony naso-orbital-ethmoid (NOE) complex is a 3-dimensional delicate anatomic structure. Damages to this region may result in severe facial dysfunction and malformation. The management and optimal surgical treatment strategies of NOE fractures remain controversial. For a patient with NOE trauma, doctors should perform comprehensive clinical examination and radiographic analysis to assess the type and extent of fracture. The results of assessment will assist doctors to make a patient-specific program for the sake of reducing post-operation complications and restoring normal appearance and function as much as possible. This review focuses on the advancement of management of NOE fractures including symptoms, classifications, diagnosis, approaches, treatment and new techniques in this field.Due to the naso-orbital-ethmoid (NOE) complex's intricate anatomy, the fracture in this region has been one of the most challenging to manage in maxillofacial trauma. The NOE complex is a 3-dimensional delicate anatomic structure. Damage to any structure in this region, even minimal, is quite likely to result in the facial function and appearance abnormal. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPTFurthermore, this complex structure has a compact relationship with the brain and eyes, because it separates the nasal, orbital cavities from cranial cavity. Therefore, as long as the fracture of the region is suspected, a thorough physical examination and radiographic assessment, such as 2-dimensional (2D) CT and 3-dimensional (3D) CT, must be performed to assess the type and extent of fracture after achieving the stable vital signs.At present, different types of approaches for exposure have been discussed, such as midfacial degloving and endoscopic approach, as well as management of the NOE fracture, such as bone tissue engineering. However, every procedure has its advantages and disadvantages. According to individual injures, the surgeon should select the patient-specific treatment to restore the normal facial function and appearance. This review will discuss the advancement in the field of NOE fracture management. NOE anatomy Bony structure: the NOE complex consists of the nasal bones, frontal process of the maxilla, nasal process of the frontal bone, lacrimal bone, lamina papyracea, ethmoid bone, sphenoid bone and nasal septum, which separate the nasal, orbital cavities from cranial cavity. 1,2 The medial orbital wall is made up of the lacrimal bone and the lamina papyracea of the ethmoid where blowout fracture is easy to occur (Figure 1). 1 Medial canthal tendon (MCT): MCT is the pivotal soft tissue in NOE area, which supports the canthus, enables proper apposition between the eyelid and the globe, and performs as the lacrimal pump. 2 However, there are many controversies on the anatomy of MCT. The main controversy is on the number of the tendon's limbs. Some scholars referred that it had three limbs: anterior, superior, posterior, 2 some others argued that the superior limb did not exist. 3 Furthermore, some report...

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Section: Computer Applicationsmentioning

confidence: 99%

The management of naso-orbital-ethmoid (NOE) fractures

Wei

Tang

Liu

et al. 2015

Chinese Journal of Traumatology

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“…Studies on cadavers with soft tissue [15][16][17][18] are more elaborate, and are practically limited to a feasible number of measurements, especially if these are to be processed manually. A common example is the acquisition of distances between marked anatomical reference points, which are few by nature.…”

Section: Introductionmentioning

confidence: 99%

“…For example, in the case of craniomaxillofacial implant position planning, the implant insertion length and thus the bone thickness of the bone models is investigated. Measurement points are retrieved manually or automatically from intensity profile lines [15] or visually from the voxel data [17], not from the calculated surface meshes, and possibly in specific anatomical planes [18].…”

Section: Introductionmentioning

confidence: 99%

Accuracy assessment of CT-based outer surface femur meshes

Gelaude

Sloten

Lauwers

2008

Computer Aided Surgery

102

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Objectives: Computer-aided bone surgery planning and implant design applications require accurate and compact representations of the patient's bone. The accuracy of bone segmentation from medical images has been studied extensively, with each study using a specific ground truth and a specific type and number of accuracy measurements. However, for convenience and practical reasons these three specifications have always been limited. The goal of this study is to thoroughly assess the absolute 3D accuracy of CT-based bone outer surface meshes, using femora as the examples. Materials and Methods: Using dense and very accurate optical surface scans of 15 dried femora as an absolute ground truth, this paper reports on the absolute 3D geometric accuracy of triangulated bone outer surface meshes, which were segmented from the CT scans of the corresponding formalin-fixed intact cadaver specimens using the author's previously presented contour-based segmentation algorithm on the one hand, and the commercially available Mimics Õ software (Materialise N.V., Leuven, Belgium) on the other. The study incorporates the effect of soft tissue presence on hard tissue segmentation and simultaneously reveals the accuracy shift introduced as a result of boiling the cadaver bones by processing extra CT scans of the dried bones. Results: The presented study demonstrates that, when using the optimal parameter settings for the respective segmentation procedures, sub-voxel mesh accuracies can be attained. Compact surface representations of femora can be generated with mean absolute accuracies of up to one fifth of the voxel size and Root Mean Square (RMS) error of half the voxel size. Conclusions: The 3D accuracy of the contour-based segmentation previously presented by the author makes it most suitable for generating outer bone surface meshes for use in the aforementioned applications. The optimal parameter settings for this segmentation procedure have been identified. For the Mimics Õ bone surface meshes, a single, but excellent, pre-defined set of parameters was identified.

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“…Numerous materials have been used for orbital tissue reconstruction including lyophilized dura, silastic polyethylene or polydioxanone sheets, hydroxyapatite blocks, titanium mesh, ceramic inlays and autogenous bone grafts. 12,13 The more elastic materials are unable to withstand the dynamic stresses of large defects. Resorbable implants may be prone to foreign-body reaction and implant exposure.…”

mentioning

confidence: 99%

“…In addition, implant resorption can occur. 12,13 Titanium mesh has a long track record of reconstruction of large orbital floor defects and correction of globe malposition. Some advantages of titanium mesh plates are availability, biocompatibility, easy intraoperative contouring and rigid fixation.…”

mentioning

confidence: 99%

Orbital Trauma: Keep an Eye for the Details!

Vv²,

Varma³

2012

The Journal of Contemporary Dental Practice

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Orbital injuries are often missed out when they occur concomitantly with other facial bone fractures. Clinical examination and plain radiographic findings alone may prove inadequate in the detection of orbital floor fractures. Refined imaging techniques like CT scans and MRI are immensely helpful in the diagnosis of orbital blowout fractures. A case of 'impure' orbital blowout fracture which went undetected at the time of initial examination and its secondary surgical reconstruction is reported here. This case report emphasizes the importance of careful clinical and radiologic evaluation in orbital injuries.

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Anatomical 3-dimensional Pre-bent Titanium Implant for Orbital Floor Fractures

Cited by 108 publications

References 39 publications

The management of naso-orbital-ethmoid (NOE) fractures

The management of naso-orbital-ethmoid (NOE) fractures

Accuracy assessment of CT-based outer surface femur meshes

Orbital Trauma: Keep an Eye for the Details!

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