Surgical Outcomes of Orbital Fracture Reconstruction Using Patient-Specific Implants

Blumer, Michael; Essig, Harald; Steigmiller, Klaus; Wagner, Maximilian; Gander, Thomas

doi:10.1016/j.joms.2020.12.029

Cited by 13 publications

(17 citation statements)

References 19 publications

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“…Preoperative enophthalmos was recorded by Blumer et al 28 in 6 of 26 (23%) of cases, and a solitary case of enophthalmos was recorded postoperatively (4%). Preoperative enophthalmos was recorded by Kim et al 25 in 3 of 22 (14%) cases.…”

Section: Resultsmentioning

confidence: 96%

“…Three small uncontrolled cohort studies evaluated postoperative outcomes of fully customized orbital PSI (Table 1). 23,25,28 Preoperative diplopia was recorded by Blumer et al 28 in 10 of 26 (38%) cases, by Kim et al 25 in 3 of 22 (14%) cases, and by Kärkkäinen et al 23 in 8 of 15 (53%) cases. Blumer et al 28 reported postoperative diplopia in 9 of 26 (35%) cases, and Kärkkäinen et al 23 reported postoperative diplopia in 6 of 15 (40%) cases.…”

Section: Resultsmentioning

confidence: 99%

“…23,25,28 Preoperative diplopia was recorded by Blumer et al 28 in 10 of 26 (38%) cases, by Kim et al 25 in 3 of 22 (14%) cases, and by Kärkkäinen et al 23 in 8 of 15 (53%) cases. Blumer et al 28 reported postoperative diplopia in 9 of 26 (35%) cases, and Kärkkäinen et al 23 reported postoperative diplopia in 6 of 15 (40%) cases. Zero postoperative diplopia cases were reported by Kim et al 25 Preoperative enophthalmos was recorded by Blumer et al 28 in 6 of 26 (23%) of cases, and a solitary case of enophthalmos was recorded postoperatively (4%).…”

Section: Resultsmentioning

confidence: 99%

“…13,[15][16][17][18][19]21,27 In 4 (27%) studies, the PSI was fully individualized, and directly manufactured from a 3D printer. [23][24][25]28 Three studies (20%) detailed the fabrication of a template from a 3D printer. The template was used to either: harvest accurately sized autogenous bone graft to match the defect from the orbital fracture 30 or to accurately manufacture a PSI from preformed materials.…”

Section: Resultsmentioning

confidence: 99%

“…When a manual molding technique was utilized, diplopia was reported postoperatively in 0%–60% of cases, 13,16,18,27 and enophthalmos persisted in 0%–20% of cases. 15,19,21,27 When fully customized PSI were utilized, postoperative diplopia was recorded at a rate of 35% and 40% in 2 small, uncontrolled series, 23,28 and enophthalmos was recorded in a solitary case. 28 With one exception, 19 all studies that recorded postoperative orbital volume reported that the repaired volume was comparable to the contralateral orbit.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Patient-specific Implants for Orbital Fractures: A Systematic Review

Maher

Hall

Gwini

et al. 2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: Orbital fractures are common facial fractures that can be challenging to repair and require careful attention to avoid unacceptable ophthalmic complications. Customized implants that are unique to an individual patient, or patientspecific implants (PSIs), have been increasingly used to repair orbital wall fractures. This systematic review summarizes the current evidence regarding custom-made orbital wall implants.Methods: A keyword search of published literature from January 2010 to September 2021 was performed using Ovid MEDLINE, PubMed, and the Cochrane Library databases. Original articles that included more than 3 human subjects with an orbital fracture repaired with a PSI were included. The search results were reviewed, duplicates were removed and relevant articles were included for analysis.Results: Fifteen articles meeting the inclusion criteria. The articles were categorized into 3 separate groups based on the method of PSI fabrication: manual molding of a PSI on a 3D-printed orbital model (53%), directly from a 3D printer (27%), or via a template fabricated from a 3D printer (20%). Three primary postoperative outcomes were assessed: rates of diplopia, enophthalmos, and orbital volume. Postoperative rates of diplopia and enophthalmos improved regardless of the PSI technique, and postoperative orbital volumes were reduced compared with their preoperative state. When PSIs were compared to conventional implants, patient outcomes were comparable.Conclusions: This review of existing PSI orbital implant literature highlights that while PSI can accurately and safely repair orbital fractures, patient outcomes are largely comparable to orbital fractures repaired by conventional methods, and PSI do not offer a definitive benefit over conventional implants.

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Section: Resultsmentioning

confidence: 96%