Individual preformed titanium meshes for orbital fractures

Computer applications in facial plastic and reconstructive surgery

PURPOSE OF REVIEW

Computer applications in facial plastic and reconstructive surgery continue to evolve as image-guided surgical technology and software applications improve. Surgeons use these technological advances in order to simplify complex and historically challenging reconstructive issues. This paper reviews the recent literature pertaining to advances in computer-aided presurgical planning and intraoperative navigation.

RECENT FINDINGS

Although many different computer-aided surgical applications have previously been described, the recent literature focuses on orbital, midface and mandibular reconstruction. These studies highlight primary and secondary repair of complex maxillofacial trauma using computer software platforms for analysis of computed tomography data, presurgical planning, and intraoperative navigation.

SUMMARY

Computer-assisted facial reconstructive surgery is an area which continues to evolve. The current technology is best served in the repair of complex primary or secondary posttraumatic deformities. Congenital and oncologic reconstructive applications, however, are growing rapidly. While computer-aided surgery has historically been limited to tertiary care centers, easy access to intraoperative navigation systems and more user friendly software applications make these techniques more accessible to a greater number of surgeons.

Individually preformed titanium mesh implants for a true-to-original repair of orbital fractures

The purpose of this investigation is to present the results using preoperatively-formed titanium mesh implants for a true-to-original primary repair of extensive orbital floor and medial wall fractures. Individually preformed implants were used to repair extensive orbital floor injuries in 19 patients at the University Hospital, Freiburg. The form of the orbital floor and walls was analysed by preoperative diagnostic CT scan data. The form of the virtual reconstructed orbit was transformed into a model of the orbital cavity by a template machine. Postoperative imaging by or CT scan verified the exact 3D reconstruction of the orbital cavity 'true to original'. None of the patients demonstrated diplopia or enophthalmos postoperatively. Using individually preformed titanium mesh implants, the accuracy of the 3D orbital reconstruction was within a range of 1mm. The reconstruction using preformed implants proved to be less time consuming, more precise and less invasive, compared to 'free hand' efforts, for the repair of orbital injuries using titanium mesh and calvarial grafts.