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Virtual surgery simulation in orbital wall reconstruction: integration of surgical navigation and stereolithographic models.
- Source :
-
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery [J Craniomaxillofac Surg] 2014 Dec; Vol. 42 (8), pp. 2025-34. Date of Electronic Publication: 2014 Oct 05. - Publication Year :
- 2014
-
Abstract
- Purpose: Correction of post traumatic orbital and zygomatic deformity is a challenge for maxillofacial surgeons. Integration of different technologies, such as software planning, surgical navigation and stereolithographic models, opens new horizons in terms of the surgeons' ability to tailor reconstruction to individual patients. The purpose of this study was to analyze surgical results, in order to verify the suitability, effectiveness and reproducibility of this new protocol.<br />Methods: Eleven patients were included in the study. Inclusion criteria were: unilateral orbital pathology; associated diplopia and enophthalmos or exophthalmos, and zygomatic deformities. Syndromic patients were excluded. Pre-surgical planning was performed with iPlan 3.0 CMF software and we used Vector Vision II (BrainLab, Feldkirchen, Germany) for surgical navigation. We used 1:1 skull stereolithographic models for all the patients. Orbital reconstructions were performed with a titanium orbital mesh. The results refer to: correction of the deformities, exophthalmos, enophthalmos and diplopia; correspondence between reconstruction mesh positioning and preoperative planning mirroring; and the difference between the reconstructed orbital volume and the healthy orbital volume.<br />Results: Correspondence between the post-operative reconstruction mesh position and the presurgical virtual planning has an average margin of error of less than 1.3 mm. In terms of en- and exophthalmos corrections, we have always had an adequate clinical outcome with a significant change in the projection of the eyeball. In all cases treated, there was a complete resolution of diplopia. The calculation of orbital volume highlighted that the volume of the reconstructed orbit, in most cases, was equal to the healthy orbital volume, with a positive or negative variation of less than 1 cm(3).<br />Conclusion: The proposed protocol incorporates all the latest technologies to plan the virtual reconstruction surgery in detail. The results obtained from our experience are very encouraging and lead us to pursue this path.<br /> (Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Biocompatible Materials chemistry
Diplopia surgery
Enophthalmos surgery
Exophthalmos surgery
Female
Humans
Image Processing, Computer-Assisted methods
Male
Middle Aged
Orbital Fractures surgery
Orbital Neoplasms surgery
Reproducibility of Results
Surgical Mesh
Titanium chemistry
Treatment Outcome
Young Adult
Zygoma surgery
Zygomatic Fractures surgery
Computer-Aided Design
Models, Anatomic
Orbit surgery
Patient Care Planning
Plastic Surgery Procedures methods
Surgery, Computer-Assisted methods
User-Computer Interface
Subjects
Details
- Language :
- English
- ISSN :
- 1878-4119
- Volume :
- 42
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 25458348
- Full Text :
- https://doi.org/10.1016/j.jcms.2014.09.009