Primary Orbital Fracture Repair

Holmes, Simon

doi:10.1016/j.cxom.2020.11.004

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…Blow-in fractures are often caused by high impact damage to the lateral wall or roof and can decrease the orbital volume. 3 Indications for surgical repair of orbital fractures include trap door mechanism with soft tissue incarceration, ocular motility restriction, persistent diplopia, globe malposition, or significant enophthalmos. The goals of fracture repair are restoring orbital volume and unrestricted extraocular muscle function, maintaining symmetric globe position with the contralateral side, and preventing long-term sequalae and facial disfigurement.…”

Section: Overview Of the Traditional Approach To Acute Orbital Traumamentioning

confidence: 99%

Virtual Planning and 3D Printing in the Management of Acute Orbital Fractures and Post-Traumatic Deformities

et al. 2022

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Virtual surgical planning (VSP) and three-dimensional (3D) printing have advanced surgical reconstruction of orbital defects. Individualized 3D models of patients' orbital bony and soft tissues provide the surgeon with corrected orbital volume based on normalized anatomy, precise location of critical structures, and when needed a better visualization of the defect or altered anatomy that are paramount in preoperative planning. The use of 3D models preoperatively allows surgeons to improve the accuracy and safety of reconstruction, reduces intraoperative time, and most importantly lowers the rate of common postoperative complications, including over- or undercontouring of plates, orbital implant malposition, enophthalmos, and hypoglobus. As 3D printers and materials become more accessible and cheaper, the utility of printing patient-specific implants becomes more feasible. This article summarizes the traditional surgical management of orbital fractures and reviews advances in VSP and 3D printing in this field. It also discusses the use of in-house (point-of-care) VSP and 3D printing to further advance care of acute orbital trauma and posttraumatic deformities.

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Section: Overview Of the Traditional Approach To Acute Orbital Traumamentioning

confidence: 99%

Virtual Planning and 3D Printing in the Management of Acute Orbital Fractures and Post-Traumatic Deformities

et al. 2022

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“…Post-traumatic orbital wall defect is a frequently managed clinical scenario for craniomaxillofacial surgeons, ophthalmologists, and oculoplastic surgeons [1]. Disconcerting symptoms such as enophthalmos, diplopia, hypoglobus, restricted motility of extraocular muscles, and disturbances in visual acuity often complicate these fractures [2,3]. After the initial management of globe injury and any threat to vision, the goals of management in traumatic orbital wall fractures are to restore the pre-injury orbital volume, thereby correcting the enophthalmos, release any entrapped orbital contents, resolve diplopia (if present), and prevent diplopia in the long-term restoration [4,5].…”

Section: Introductionmentioning

confidence: 99%

Is the Pre-Shaping of an Orbital Implant on a Patient-Specific 3D-Printed Model Advantageous Compared to Conventional Free-Hand Shaping? A Systematic Review and Meta-Analysis

Singh

Khanal

Chaulagain

et al. 2023

JCM

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This study aimed to perform a systematic review and meta-analysis to compare pre-shaped implants on a patient-specific 3D-printed (3DP) model to manual free-hand shaping (MFS) for orbital wall reconstruction. The PRISMA protocol was followed in this study, and the review was registered in the PROSPERO database (CRD42021261594). A search was conducted in MEDLINE (PubMed), Embase, Cochrane Library, Clinicaltrials.gov, Google Scholar, and the grey literature. Ten articles were included, and six outcomes were analyzed. In total, 281 patients were in the 3DP group and 283 were in the MFS group. The studies had an overall high risk of bias. 3DP models resulted in a better accuracy of fit, anatomical angle reproduction, and defect area coverage. The correction of orbital volume was also superior with statistical significance. There was a higher percentage of the correction of enophthalmos and diplopia in the 3DP group. Intraoperative bleeding and hospital stay were reduced in the 3DP group. The meta-analysis of operative time showed a reduction in the average operative time by 23.58 min (95% CI: −43.98 to −3.19), which was statistically significant (t(6) = −2.8299, p = 0.0300). The 3DP models appear advantageous for an accurate orbital wall reconstruction, with fewer complications than those for conventional free-hand-shaped implants.

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“…The base of the orbit, the orbital rim, is composed of thick bone; in contrast, the orbit's inner walls are thin bony structures. The orbit provides the casing for the soft-tissue structures associated with the visual (motor) system: neurovascular structures, connective tissue, ocular muscles, and the globe [4,5].…”

Section: Introductionmentioning

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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Primary Orbital Fracture Repair

Cited by 7 publications

References 24 publications

Virtual Planning and 3D Printing in the Management of Acute Orbital Fractures and Post-Traumatic Deformities

Virtual Planning and 3D Printing in the Management of Acute Orbital Fractures and Post-Traumatic Deformities

Is the Pre-Shaping of an Orbital Implant on a Patient-Specific 3D-Printed Model Advantageous Compared to Conventional Free-Hand Shaping? A Systematic Review and Meta-Analysis

Personalized Medicine Workflow in Post-Traumatic Orbital Reconstruction

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