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Chodankar NU, Dhupar V, Akkara F, Vijay V. Matrixmidface Preformed Orbital Implants for Three-Dimensional Reconstruction of Orbital Floor and Medial Wall Fractures: A Prospective Clinical Study. Craniomaxillofac Trauma Reconstr 2024; 17:104-114. [PMID: 38779396 PMCID: PMC11107816 DOI: 10.1177/19433875231171749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Study Design Prospective Interventional study. Objective To evaluate the efficiency of Matrixmidface preformed Orbital plates for three-dimensional reconstruction of orbital floor and medial wall fractures. Methods This prospective institutional clinical study was conducted on a group of 14 patients who underwent repair of orbital floor and medial wall fracture defects using Matrixmidface Preformed Orbital plates and open reduction and internal fixation of associated fractures. The following parameters were studied preoperative and postoperative enophthalmos, hypoglobus, orbital volume; correction of diplopia, intraoperative and postoperative complications. Results All 14 patients were males aged between 19 and 42 years. The most common mode of injury was found to be road traffic accidents (RTAs) followed by self-fall and trauma at workplace. Orbital fractures were associated with other concomitant maxillofacial fractures in 12 patients (85.7%) while 2 patients (14.3%) had pure blowout fractures. Significant improvement of enophthalmos was noted from preoperative period to 1 week, 6 weeks, and 6 months postoperatively (P value .02, .01, and .01, respectively). Out of 11 patients with preoperative hypoglobus, 5 patients (45.45%) had persistent hypoglobus in the immediate postoperative period which reduced to 4 patients (36.36%) at 6 weeks postoperatively (p value .00). The postoperative orbital volume of fractured side ranged from 20.3 cm3 to 26.76 cm3 with a mean of 23.50 cm3 ± 1.74. The mean difference between the volumes of the repaired and uninjured sides was found to be .27 cm3 ± .39 (P value .02) denoting that the reconstruction of the orbit closely approximated that of the uninjured side. Conclusions The Matrixmidface Preformed Orbital plate provides exceptional reconstruction of the orbital blowout fracture defects and ensures satisfactory results clinically and radiographically. The plate ensures an approximate recreation of topographical anatomy of the orbit and adequately restores the orbital volume. It provides adequate correction of asymmetry, hypoglobus, enophthalmos and attempts to restore eye movements, without causing any significant postoperative complication.
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Affiliation(s)
- Neha Umakant Chodankar
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, India
| | - Vikas Dhupar
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, India
| | - Francis Akkara
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, India
| | - Vathsalya Vijay
- Department of Ophthalmology, Goa Medical College and Hospital, Bambolim, India
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Li W, Song H, Ai D, Shi J, Wang Y, Wu W, Yang J. Semi-supervised segmentation of orbit in CT images with paired copy-paste strategy. Comput Biol Med 2024; 171:108176. [PMID: 38401453 DOI: 10.1016/j.compbiomed.2024.108176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/06/2024] [Accepted: 02/18/2024] [Indexed: 02/26/2024]
Abstract
The segmentation of the orbit in computed tomography (CT) images plays a crucial role in facilitating the quantitative analysis of orbital decompression surgery for patients with Thyroid-associated Ophthalmopathy (TAO). However, the task of orbit segmentation, particularly in postoperative images, remains challenging due to the significant shape variation and limited amount of labeled data. In this paper, we present a two-stage semi-supervised framework for the automatic segmentation of the orbit in both preoperative and postoperative images, which consists of a pseudo-label generation stage and a semi-supervised segmentation stage. A Paired Copy-Paste strategy is concurrently introduced to proficiently amalgamate features extracted from both preoperative and postoperative images, thereby augmenting the network discriminative capability in discerning changes within orbital boundaries. More specifically, we employ a random cropping technique to transfer regions from labeled preoperative images (foreground) onto unlabeled postoperative images (background), as well as unlabeled preoperative images (foreground) onto labeled postoperative images (background). It is imperative to acknowledge that every set of preoperative and postoperative images belongs to the identical patient. The semi-supervised segmentation network (stage 2) utilizes a combination of mixed supervisory signals from pseudo labels (stage 1) and ground truth to process the two mixed images. The training and testing of the proposed method have been conducted on the CT dataset obtained from the Eye Hospital of Wenzhou Medical University. The experimental results demonstrate that the proposed method achieves a mean Dice similarity coefficient (DSC) of 91.92% with only 5% labeled data, surpassing the performance of the current state-of-the-art method by 2.4%.
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Affiliation(s)
- Wentao Li
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, 100081, China.
| | - Hong Song
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, 100081, China.
| | - Danni Ai
- School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China.
| | - Jieliang Shi
- Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
| | - Yuanyuan Wang
- School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China.
| | - Wencan Wu
- Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
| | - Jian Yang
- School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China.
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Sigron GR, Britschgi CL, Gahl B, Thieringer FM. Insights into Orbital Symmetry: A Comprehensive Retrospective Study of 372 Computed Tomography Scans. J Clin Med 2024; 13:1041. [PMID: 38398354 PMCID: PMC10889405 DOI: 10.3390/jcm13041041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Background: The operation planning and production of individualized implants with the help of AI-based software after orbital fractures have become increasingly important in recent years. This retrospective study aimed to investigate the healthy orbitae of 372 patients from CT images in the bone and soft tissue windows using the Disior™ Bonelogic™ CMF Orbital software. (version 2.1.28). Methods: We analyzed the variables orbital volume, length, and area as a function of age and gender and compared bone and soft tissue windows. Results: For all variables, the intraclass correlation showed excellent agreement between the bone and soft tissue windows (p < 0.001). All variables showed higher values when calculated based on bone fenestration with, on average, 1 mL more volume, 0.35 mm more length, and 0.71 cm2 more area (p < 0.001). Across all age groups, men displayed higher values than women with, on average, 8.1 mL larger volume, a 4.78 mm longer orbit, and an 8.5 cm2 larger orbital area (p < 0.001). There was also a non-significant trend in all variables and both sexes toward growth with increasing age. Conclusions: These results mean that, due to the symmetry of the orbits in both the bone and soft tissue windows, the healthy orbit can be mirrored for surgical planning in the event of a fracture.
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Affiliation(s)
- Guido R. Sigron
- Department of Oral and Cranio-Maxillofacial Surgery and 3D Print Lab, University Hospital Basel, CH-4031 Basel, Switzerland; (C.L.B.); (F.M.T.)
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland
| | - Céline L. Britschgi
- Department of Oral and Cranio-Maxillofacial Surgery and 3D Print Lab, University Hospital Basel, CH-4031 Basel, Switzerland; (C.L.B.); (F.M.T.)
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland
| | - Brigitta Gahl
- Surgical Outcome Research Center, Department of Clinical Research, University Hospital Basel, University of Basel, CH-4031 Basel, Switzerland;
| | - Florian M. Thieringer
- Department of Oral and Cranio-Maxillofacial Surgery and 3D Print Lab, University Hospital Basel, CH-4031 Basel, Switzerland; (C.L.B.); (F.M.T.)
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland
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Milham N, Schmutz B, Cooper T, Hsu E, Hutmacher DW, Lynham A. Are Magnetic Resonance Imaging-Generated 3Dimensional Models Comparable to Computed Tomography-Generated 3Dimensional Models for Orbital Fracture Reconstruction? An In-Vitro Volumetric Analysis. J Oral Maxillofac Surg 2023; 81:1116-1123. [PMID: 37336493 DOI: 10.1016/j.joms.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/22/2023] [Accepted: 05/29/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is being increasingly considered as an alternative for the evaluation and reconstruction of orbital fractures. No previous research has compared the orbital volume of an MRI-imaged, three-dimensional (3D), reconstructed, and virtually restored bony orbit to the gold standard of computed tomography (CT). PURPOSE To measure the orbital volumes generated from MRI-based 3D models of fractured bony orbits with virtually positioned prebent fan plates in situ and compare them to the volumes of CT-based virtually reconstructed orbital models. STUDY DESIGN This retrospective in-vitro study used CT and MRI data from adult patients with orbital trauma assessed at the Royal Brisbane and Women's Hospital Outpatient Maxillofacial Clinic from 2011 to 2012. Only those with orbital blowout fractures were included in the study. PREDICTOR VARIABLE The primary predictor variable was imaging modality, with CT- and MRI-based 3D models used for plate bending and placement. MAIN OUTCOME VARIABLE The primary outcome variable was the orbital volume of the enclosed 3D models. COVARIATES Additional data collected was age, sex, and side of fractured orbit. The effect of operator variability on plate contouring and orbital volume was quantified. ANALYSES The Wilcoxon signed rank test was used to assess differences between orbital volumes with a significance level P < .05. RESULTS Of 11 eligible participants, six patients (four male and two female; mean age 31 ± 8.6 years) were enrolled. Two sets of six CT-based virtually restored orbits were smaller than the intact contralateral CT models by an average of 1.02 cm3 (95% CI -0.07 to 2.11 cm3; P = .028) and 0.99 cm3 (95% CI 0.07 to 1.91 cm3; P = .028), respectively. The average volume difference between the MRI-based virtually restored orbit and the intact contralateral MRI model was 0.97 cm3 (95% CI -1.08 to 1.94 cm3; P = .75). Imaging modality did affect orbital volume difference for 1 set of CT and MRI models (0.63 cm3; 95% CI -0.11 to 1.29 cm3; P = .046) but not the other (0.69 cm3; 95% CI -0.11 to 1.23 cm3; P = .075). Single operator variability in plate bending did not result in significant (P = .75) volume differences. CONCLUSIONS MRI can be used to reconstruct orbital volume with a clinically acceptable level of accuracy.
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Affiliation(s)
- Nicole Milham
- Registrar, Department of Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia.
| | - Beat Schmutz
- Principal Research Fellow, School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology; Jamieson Trauma Institute, Metro North Hospital and Health Service; Centre for Biomedical Technologies, Queensland University of Technology; ARC Training Centre for Multiscale 3D Imaging, Modelling, Manufacturing, Queensland University of Technology, Brisbane, Australia
| | - Thomas Cooper
- Fellow in Oral and Maxillofacial Surgery, Canberra Hospital, Canberra, Australia
| | - Edward Hsu
- Senior Staff Specialist, Department of Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Dietmar W Hutmacher
- Distinguished Professor, School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Centre for Biomedical Technologies, Queensland University of Technology, ARC Training Centre for Multiscale 3D Imaging, Modelling, Manufacturing, Queensland University of Technology, Max Planck Queensland Centre for the Materials Science of Extracellular Matrices, Jamieson Trauma Institute, Metro North Hospital and Health Service, Brisbane, Australia
| | - Anthony Lynham
- Associate Professor, Jamieson Trauma Institute, Metro North Hospital and Health Service, Brisbane, Australia
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3D printing for orbital volume anatomical measurement. SURGICAL AND RADIOLOGIC ANATOMY : SRA 2022; 44:991-998. [PMID: 35779076 DOI: 10.1007/s00276-022-02968-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/20/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE The aim was to develop a method for reproducible orbital volume (OV) measurement in vivo based on 3D printing. METHODS Twelve orbits were obtained from dry skulls of the Human Anatomy Department of Lille University. Computer tomography (CT) slice images of these orbits were transformed into stereo-lithography (STL) format and 3D-printed. Bone openings were closed using either putty and cellophane after printing (3D-Orb-1) or at the printing stage in silico using MeshMixer (3D-Orb-2). The results were compared with those of the conventional water-filling method as a control group (Anat-Orb). RESULTS The observers reported a mean orbital volume of 21.3 ± 2.1 cm3 for the open-skull method, 21.2 ± 2.4 cm3 for the non-sealed 3D-printing method, and 22.2 ± 2.0 cm3 for the closed-print method. Furthermore, the intraclass correlation coefficients (ICCs) showed excellent intra-rater agreement, i.e., an ICC of 0.994 for the first observer and 0.998 for the second, and excellent interobserver agreement (ICC: 0.969). The control and 3D-Orb-1 groups show excellent agreement (ICC: 0.972). The 3D-Orb-2 exhibits moderate agreement (ICC: 0.855) with the control and appears to overestimate orbital volume slightly. CONCLUSION Our 3D-printing method provides a standardized and reproducible method for the measurement of orbital volume.
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Hamwood J, Schmutz B, Collins MJ, Allenby MC, Alonso-Caneiro D. A deep learning method for automatic segmentation of the bony orbit in MRI and CT images. Sci Rep 2021; 11:13693. [PMID: 34211081 PMCID: PMC8249400 DOI: 10.1038/s41598-021-93227-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 06/15/2021] [Indexed: 12/23/2022] Open
Abstract
This paper proposes a fully automatic method to segment the inner boundary of the bony orbit in two different image modalities: magnetic resonance imaging (MRI) and computed tomography (CT). The method, based on a deep learning architecture, uses two fully convolutional neural networks in series followed by a graph-search method to generate a boundary for the orbit. When compared to human performance for segmentation of both CT and MRI data, the proposed method achieves high Dice coefficients on both orbit and background, with scores of 0.813 and 0.975 in CT images and 0.930 and 0.995 in MRI images, showing a high degree of agreement with a manual segmentation by a human expert. Given the volumetric characteristics of these imaging modalities and the complexity and time-consuming nature of the segmentation of the orbital region in the human skull, it is often impractical to manually segment these images. Thus, the proposed method provides a valid clinical and research tool that performs similarly to the human observer.
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Affiliation(s)
- Jared Hamwood
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology (QUT), Kelvin Grove, Qld, 4059, Australia
| | - Beat Schmutz
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia
- Metro North Hospital and Health Service, Jamieson Trauma Institute, Herston, QLD, 4029, Australia
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology (QUT), Kelvin Grove, Qld, 4059, Australia
| | - Mark C Allenby
- Biofabrication and Tissue Morphology Laboratory, Centre for Biomedical Technologies, School of Mechanical Medical and Process Engineering, Queensland University of Technology (QUT), Herston, Qld, 4000, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology (QUT), Kelvin Grove, Qld, 4059, Australia.
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XU LIN, TAN JIA, WEI PINGOU, LUO XIANG, TAN HAITAO, MUDGAL CHAITANYASHAMSUNDER. CLINICAL APPLICATION OF 3D PRINTING TECHNOLOGY FOR PREOPERATIVE PLANNING OF THUMB RECONSTRUCTION. ACTA ORTOPEDICA BRASILEIRA 2021; 29:211-218. [PMID: 34566481 PMCID: PMC8443019 DOI: 10.1590/1413-785220212904235492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/24/2020] [Indexed: 11/21/2022]
Abstract
Objective: This study aimed to explore the clinical application of preoperative precise design for 3D printing and thumb reconstruction, which could help manage the patients with thumb defect and achieve better function and appearance. Methods: This was a retrospective study of 20 patients who underwent the surgery of harvesting toe transplant and thumb reconstruction between January 2015 and December 2016. The 3D model of the thumb defect was created and printed. The dimensions of skin and bones from donor site were precisely designed as reference for surgical operation. The surgery was performed according to the model. Results: Perfect repair of defects was achieved with satisfying appearance and function. The reconstructed thumbs all survived (survival rate of 100%). Follow-up was 3-9 months. The maximum dorsiflexion was 8-30° and the maximum flexion was 38-58°. The two-point sensory discrimination was 9-11 mm. In total, 17 patients reposted “Excellent” satisfaction and three “Good”, each for the reconstructed thumb and hand function, respectively. The satisfaction rate was 85%. Conclusion: Preoperative digital design and 3D printing according to the donor and recipient sites allowed a tailored operation. The operation was more precise, the appearance of the reconstructed thumb was good. Level of Evidence II, Retrospective Study.
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Affiliation(s)
- LIN XU
- Guigang City People’s Hospital, China
| | - JIA TAN
- Guangzhou Medical University First Clinical Medical College, China
| | | | - XIANG LUO
- Guangxi Clinical Research Center for Digital Medicine and 3D Printing, China
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Gupta S, Mehrotra D, Singh PK, U V, Bhave S, Katrolia R. Quality of life after reconstruction of traumatic orbital floor defects using titanium mesh and medpore: A randomised controlled trial. J Oral Biol Craniofac Res 2021; 11:200-203. [PMID: 33665067 PMCID: PMC7897992 DOI: 10.1016/j.jobcr.2021.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/14/2021] [Indexed: 11/19/2022] Open
Abstract
AIM AND OBJECTIVES The aim of this study was to analyse the outcomes of orbital floor reconstruction with two types of orbital implants and assess patients' quality of life. MATERIAL AND METHODS 39 sequential patients with clinical and radiological evidence of orbital floor fracture, presenting diplopia, enophthalmos, paraesthesia or a post traumatic residual orbital deformity were included in this study and randomised for orbital floor reconstruction using porous polyethylene sheet (Biopore™) or preshaped titanium mesh on a 3D model. Their pre and postoperative quality of life were compared. Success rate was assessed and scored with a minimum of zero (none) and a maximum of ten (excellent) for improvement in the signs of diplopia, enophthalmos, hypoglobus, paraesthesia and aesthetics. RESULTS Both QOL scores and Success score was greater in cases which reconstruction of orbital floor was performed with preshaped titanium mesh as compared to those with Biopore™. CONCLUSION Preshaped titanium mesh shows better results than reconstruction with Biopore™. However a large sample size and a long term follow up is needed for generating the best evidence. Quality of life extensively improves after orbital floor reconstruction motivating the patients desire to live.
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Affiliation(s)
- Sneha Gupta
- Dept of Oral & Maxillofacial Surgery, King George’s Medical University, Lucknow, 226003, India
| | - Divya Mehrotra
- Dept of Oral & Maxillofacial Surgery, King George’s Medical University, Lucknow, 226003, India
| | - Praveen Kumar Singh
- Dept of Oral & Maxillofacial Surgery, King George’s Medical University, Lucknow, 226003, India
| | - Vignesh U
- Dept of Oral & Maxillofacial Surgery, King George’s Medical University, Lucknow, 226003, India
| | - Sujay Bhave
- Dept of Oral & Maxillofacial Surgery, King George’s Medical University, Lucknow, 226003, India
| | - Ravi Katrolia
- Dept of Oral & Maxillofacial Surgery, King George’s Medical University, Lucknow, 226003, India
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Abdelazem MH, Erdogan Ö, Awad TA. A modified endoscopic technique for the repair of isolated orbital floor fractures. EUROPEAN JOURNAL OF PLASTIC SURGERY 2020. [DOI: 10.1007/s00238-020-01645-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chepurnyi Y, Chernohorskyi D, Prykhodko D, Poutala A, Kopchak A. Reliability of orbital volume measurements based on computed tomography segmentation: Validation of different algorithms in orbital trauma patients. J Craniomaxillofac Surg 2020; 48:574-581. [PMID: 32291132 DOI: 10.1016/j.jcms.2020.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/08/2020] [Accepted: 03/19/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To compare the most common methods of segmentation for evaluation of the bony orbit in orbital trauma patients. MATERIALS AND METHODS Computed tomography scans (before and after treatment) from 15 patients with unilateral blowout fractures and who underwent orbital reconstructions were randomly selected for this study. Orbital volume measurements, volume difference measurements, prolapsed soft tissue volumes, and bony defect areas were made using manual, semi-automated, and automated segmentation methods. RESULTS Volume difference values between intact and damaged orbits after surgery using the manual mode were 0.5 ± 0.3 cm3, 0.5 ± 0.4 cm3 applying semi-automated method, and 0.76 ± 0.5 cm3, determined by automated segmentation (р = 0.216); the mean volumes (MVs) for prolapsed tissues were 3.0 ± 1.9 cm3, 3.0 ± 2.3 cm3, and 2.8 ± 3.9 cm3 (p = 0.152); and orbital wall defect areas were 4.7 ± 2.8 cm2, 4.75 ± 3.1 cm2, and 4.9 ± 3.3 cm2 (p = 0.674), respectively. CONCLUSIONS The analyzed segmentation methods had the same accuracy in evaluation of volume differences between two orbits of the same patient, defect areas, and prolapsed soft tissue volumes but not in absolute values of the orbital volume due to the existing diversity in determination of anterior closing. The automated method is recommended for common clinical cases, as it is less time-consuming with high precision and reproducibility.
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Affiliation(s)
- Yurii Chepurnyi
- Department of Stomatology, Bogomolets National Medical University, T. Shevchenko Blvd., 13, 01601, Kyiv, Ukraine.
| | - Denys Chernohorskyi
- Department of Stomatology, Bogomolets National Medical University, T. Shevchenko Blvd., 13, 01601, Kyiv, Ukraine
| | - Danylo Prykhodko
- "Imatek Medical (Co "), Prosp, Peremogy, 123, 03179, Kyiv, Ukraine
| | - Arto Poutala
- "Disior Ltd", FI27875878, Terkko Health Hub, Haartmaninkatu 4, 00290, Helsinki, Finland
| | - Andriy Kopchak
- Department of Stomatology, Bogomolets National Medical University, T. Shevchenko Blvd., 13, 01601, Kyiv, Ukraine
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Cooper T, Schmutz B, Hsu E, Lynham A. Magnetic resonance imaging for three-dimensional printing of the bony orbit: is clinical use imminent? Int J Oral Maxillofac Surg 2019; 49:483-490. [PMID: 31402077 DOI: 10.1016/j.ijom.2019.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/28/2019] [Accepted: 07/18/2019] [Indexed: 10/26/2022]
Abstract
The aim of this study was to examine the accuracy of three dimensionally (3D) printed models of the bony orbit derived from magnetic resonance imaging (MRI) for the purpose of preoperative plate bending in the setting of orbital blowout fracture. Retrospective computed tomography (CT) and MRI data from patients with suspected orbital fractures were used. Virtual models were manually generated and analysed for spatial accuracy of the fracture margins. 3D-printed models were produced and orbital fan plates bent by a single operator. The plates were then digitized and analysed for spatial discrepancy using reverse engineering software. Seven orbital blowout fractures were evident in six orbits. Analysis of the virtual models revealed high congruence between blowout fracture margins on CT and MRI (n=7, average deviation 0.85mm). Three zygomaticomaxillary complex fractures were seen, for which MRI did not demonstrate the same accuracy. For plates bent to the 3D-printed models of blowout fractures (n=6), no significant difference was found between those bent to CT versus those bent to MRI when compared for average surface and average border deviation (Wilcoxon signed rank test). Orbital blowout fractures can be defined on MRI with clinically acceptable accuracy. 3D printing of orbital biomodels from MRI for bending reconstructive plates is an acceptable and accurate technique.
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Affiliation(s)
- T Cooper
- Department of Oral and Maxillofacial Surgery, Royal Perth Hospital, Perth, Western Australia, Australia.
| | - B Schmutz
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - E Hsu
- Department of Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - A Lynham
- School of Medicine, University of Queensland, Brisbane, Australia
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Gomes de Oliveira P, Perry da Câmara C, Valejo Coelho P. Intra- and interreader variability of orbital volume quantification using 3D computed tomography for reconstructed orbital fractures. J Craniomaxillofac Surg 2019; 47:1060-1064. [DOI: 10.1016/j.jcms.2019.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/26/2019] [Accepted: 04/18/2019] [Indexed: 10/27/2022] Open
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Dong QN, Karino M, Koike T, Ide T, Okuma S, Kaneko I, Osako R, Kanno T. Navigation-Assisted Isolated Medial Orbital Wall Fracture Reconstruction Using an U-HA/PLLA Sheet via a Transcaruncular Approach. J INVEST SURG 2019; 33:644-652. [PMID: 30644798 DOI: 10.1080/08941939.2018.1546353] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: We investigated the feasibility of isolated medial orbital wall fracture reconstruction using an unsintered hydroxyapatite particles/poly L-lactide (u-HA/PLLA) sheet implant with the assistance of intraoperative navigation via the transcaruncular approach. Patients and methods: Ten consecutive patients (5 males and 5 females; mean age, 57.5 years) were included based on the clinical and imaging criteria. All patients underwent surgical treatment of the isolated medial orbital wall fracture using transcaruncular incision and the u-HA/PLLA implant under navigation. The follow-up time was greater than 6 months. Preoperative and postoperative clinical data regarding the presence of diplopia, eye motility restriction, and enophthalmos were assessed. The orbital volumes of the injured and uninjured orbit were also evaluated using computed tomography images. Results: All patients had improved ophthalmologic functional and esthetic outcomes and were successfully treated without any long-term complications arising during follow-up. There was a significant difference between the preoperative and postoperative injured orbits due to herniation of the orbital contents. Moreover, the orbital volume of the postoperative injured side following surgery was the same as that of the unaffected side, indicating that anatomically good reconstruction had been obtained. Conclusions: Surgical treatment using the transcaruncular approach and u-HA/PLLA materials with intraoperative navigation is a safe, promising, and effective technique for isolated medial orbital wall fracture reconstruction.
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Affiliation(s)
- Quang Ngoc Dong
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Masaaki Karino
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.,Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Takashi Koike
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.,Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Taichi Ide
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.,Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Satoe Okuma
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.,Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Ichiro Kaneko
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.,Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Rie Osako
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.,Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.,Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
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Three-Dimensional Printed Model and Transantral Endoscopy to Orbital Fracture Repair. J Craniofac Surg 2019; 29:e594-e595. [PMID: 29863557 DOI: 10.1097/scs.0000000000004636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Orbital fractures are high prevalent and result in several complications such as diplopia, muscular entrapment, visual impairment, and enophthalmos. The goal of orbital reconstruction is to restore orbital anatomy, volume, and globe symmetry. This case report aims to describe the use of transantral endoscopy and 3D printed model for treatment of an orbital floor fracture. A 54-year-old woman presented orbital floor fracture with diplopia and extraocular muscle entrapment. The surgical treatment was performed using a standard titanium mesh bended over 3D printed model, and transantral endoscopy to verify fracture extension and implant adaptation. The postoperative evaluation demonstrates correction of diplopia and ocular motility restriction. Computed tomography scan showed reestablishment of the orbital anatomy. The association of transantral endoscopy and 3D printed models is a feasible technique to improve orbital reconstruction.
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15
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Assessing the precision of posttraumatic orbital reconstruction through “mirror” orbital superimposition: A novel approach for testing the anatomical accuracy. J Craniomaxillofac Surg 2018; 46:1258-1262. [DOI: 10.1016/j.jcms.2018.05.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/20/2018] [Accepted: 05/16/2018] [Indexed: 11/18/2022] Open
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16
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Gribova MN, Pluijmers BI, Resnick CM, Caron CJJM, Borghi A, Koudstaal MJ, Padwa BL. Is There a Difference in Orbital Volume Between Affected and Unaffected Sides in Patients With Unilateral Craniofacial Microsomia? J Oral Maxillofac Surg 2018; 76:2625-2629. [PMID: 29859949 DOI: 10.1016/j.joms.2018.04.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 04/30/2018] [Accepted: 04/30/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE Craniofacial microsomia (CFM) is characterized by malformations of structures derived from the first and second pharyngeal arches. The orbit is variably affected. The purpose of this study was to determine whether there is a difference in orbital volume between affected and unaffected sides in patients with unilateral CFM. The specific aims were to 1) measure orbital volume, 2) compare affected and unaffected sides, 3) evaluate the correlation between clinical evaluation of orbital size and volumetric measurement, and 4) determine whether there is a correlation between orbital volume and severity of mandibular deformity. MATERIALS AND METHODS This study is a retrospective case series of patients with unilateral CFM from Boston Children's Hospital (Boston, MA) who had a computed tomographic (CT) scan. Manual segmentation of the orbit using Mimics software (Materialise, Leuven, Belgium) was performed on CT images of the 2 orbits. The predictor variable was laterality (affected vs unaffected side) and the primary outcome variable was orbital volume. Wilcoxon signed rank test was used to compare these measurements and determine whether the affected side differed from the unaffected side. The correlation between orbital volume and Pruzansky-Kaban type of mandibular deformity, as documented in the medical record, was determined using the Spearman rank correlation coefficient. RESULTS Thirty-nine patients were included. Orbital volume was 10% smaller on the affected side (P = .001) in 80% of patients. There was no correlation between orbital size and severity of mandibular involvement. CONCLUSION The results of this study showed a marked difference in orbital volume between affected and unaffected sides in patients with unilateral CFM. These differences were small and might not be clinically relevant. Orbital volume did not correlate with severity of mandibular deformity.
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Affiliation(s)
- Maria N Gribova
- Medical Student, Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Rotterdam, The Netherlands; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA.
| | - Britt I Pluijmers
- Attending Surgeon, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA
| | - Cory M Resnick
- Resident, Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Rotterdam, The Netherlands
| | - Cornelia J J M Caron
- Resident, Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Rotterdam, The Netherlands
| | - Alessandro Borghi
- Senior Research Associate, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Maarten J Koudstaal
- Attending Surgeon and Associate Professor, Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Rotterdam, The Netherlands; Associate Professor, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA; Associate Professor, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Bonnie L Padwa
- Oral Surgeon-in-Chief and Associate Professor, Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA
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Hsung TC, Lo J, Chong MM, Goto TK, Cheung LK. Orbit Segmentation by Surface Reconstruction With Automatic Sliced Vertex Screening. IEEE Trans Biomed Eng 2018; 65:828-838. [DOI: 10.1109/tbme.2017.2720184] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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18
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What Is the Incidence of Implant Malpositioning and Revision Surgery After Orbital Repair? J Oral Maxillofac Surg 2018; 76:146-153. [DOI: 10.1016/j.joms.2017.08.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 08/14/2017] [Accepted: 08/14/2017] [Indexed: 11/22/2022]
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19
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Intracranial Volume Measurement: A Systematic Review and Comparison of Different Techniques. J Craniofac Surg 2017; 28:1746-1751. [DOI: 10.1097/scs.0000000000003929] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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Comparison of the Outcomes of Complex Orbital Fracture Repair with and without a Surgical Navigation System. Plast Reconstr Surg 2017; 139:957-965. [DOI: 10.1097/prs.0000000000003229] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Mottini M, Wolf CA, Seyed Jafari SM, Katsoulis K, Schaller B. Stereographic measurement of orbital volume, a digital reproducible evaluation method. Br J Ophthalmol 2017; 101:1431-1435. [DOI: 10.1136/bjophthalmol-2016-309998] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/20/2017] [Accepted: 04/04/2014] [Indexed: 11/04/2022]
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22
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Sukegawa S, Kanno T, Shibata A, Matsumoto K, Sukegawa-Takahashi Y, Sakaida K, Furuki Y. Treatment of Orbital Fractures with Orbital-Wall Defects using Anatomically Preformed Orbital Wall Reconstruction Plate System. J HARD TISSUE BIOL 2017. [DOI: 10.2485/jhtb.26.231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Shintaro Sukegawa
- Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital
| | - Takahiro Kanno
- Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine
| | - Akane Shibata
- Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital
| | - Kenichi Matsumoto
- Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital
| | | | - Kyosuke Sakaida
- Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital
| | - Yoshihiko Furuki
- Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital
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23
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Cone-beam computed tomography of the orbit and optic canal volumes. J Craniomaxillofac Surg 2016; 44:1342-9. [DOI: 10.1016/j.jcms.2016.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 04/25/2016] [Accepted: 06/02/2016] [Indexed: 11/17/2022] Open
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24
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Can customized implants correct enophthalmos and delayed diplopia in post-traumatic orbital deformities? A volumetric analysis. Int J Oral Maxillofac Surg 2016; 45:1086-94. [DOI: 10.1016/j.ijom.2016.04.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 12/30/2015] [Accepted: 04/11/2016] [Indexed: 11/17/2022]
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25
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Is there an ideal implant for orbital reconstructions? Prospective 64-case study. J Craniomaxillofac Surg 2016; 44:1682-1688. [PMID: 27637477 DOI: 10.1016/j.jcms.2016.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/17/2016] [Accepted: 08/08/2016] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to compare the effectiveness of porous polyethylene, titanium mesh, and castor oil-derived biopolymer randomized in orbital reconstructions of defects larger than 1 cm in length on the inferior and medial walls. A total of 63 patients (64 orbits) were evaluated to determine the presence of diplopia, enophthalmos ocular motility, and infraorbital nerve paraesthesia in both the preoperative and postoperative periods. The surgeons' opinions of the ease in handling the implants were also obtained after each procedure. The patients were divided into 3 groups: 17 received porous polyethylene, 21 received castor oil-derived biopolymer, and 26 received titanium mesh. In the preoperative period, 30 patients experienced enophthalmos, 11 experienced diplopia, and 12 experienced ocular motility. Ninety days after the orbital reconstruction, 6 cases of enophthalmos persisted, as did 2 cases of diplopia and 2 cases of ocular motility. Ten patients developed some type of postoperative complication. Material removal was required in only 1 case. Regardless of the size of the defect, the materials used were found to be effective for reconstructing orbital volume; they were also found to offer ease in handling and stabilization.
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26
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Susarla SM, Duncan K, Mahoney NR, Merbs SL, Grant MP. Virtual Surgical Planning for Orbital Reconstruction. Middle East Afr J Ophthalmol 2015; 22:442-6. [PMID: 26692714 PMCID: PMC4660529 DOI: 10.4103/0974-9233.164626] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The advent of computer-assisted technology has revolutionized planning for complex craniofacial operations, including orbital reconstruction. Orbital reconstruction is ideally suited for virtual planning, as it allows the surgeon to assess the bony anatomy and critical neurovascular structures within the orbit, and plan osteotomies, fracture reductions, and orbital implant placement with efficiency and predictability. In this article, we review the use of virtual surgical planning for orbital decompression, posttraumatic midface reconstruction, reconstruction of a two-wall orbital defect, and reconstruction of a large orbital floor defect with a custom implant. The surgeon managing orbital pathology and posttraumatic orbital deformities can benefit immensely from utilizing virtual planning for various types of orbital pathology.
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Affiliation(s)
- Srinivas M. Susarla
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Katherine Duncan
- Department of Ophthalmology, University of Maryland Medical Center, Baltimore, MD, USA
| | - Nicholas R. Mahoney
- Department of Ophthalmology, Division of Oculoplastic Surgery, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Shannath L. Merbs
- Department of Ophthalmology, Division of Oculoplastic Surgery, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Michael P. Grant
- Department of Plastic and Reconstructive Surgery and Department of Ophthalmology, Division of Oculoplastic Surgery, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA
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Christensen BJ, Zaid W. Inaugural Survey on Practice Patterns of Orbital Floor Fractures for American Oral and Maxillofacial Surgeons. J Oral Maxillofac Surg 2015; 74:105-22. [PMID: 26475972 DOI: 10.1016/j.joms.2015.09.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 09/22/2015] [Accepted: 09/22/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE In recent years, several studies have reported on practitioners' preferences for the treatment of orbital floor fractures, showing widely varying practice patterns. The purpose of the present study was to identify the practice patterns among oral and maxillofacial surgeons involved in the management of orbital floor fractures in the United States and compare them with the available published data. MATERIALS AND METHODS An anonymous survey was created and electronically mailed to surgeons. We also reviewed the published data on orbital floor fractures using a PubMed and MEDLINE search. The responses to the survey were analyzed using descriptive statistics. RESULTS The factors that had the greatest influence on the surgeon's decision to operate were a defect size > 2 cm2, enophthalmos, entrapment, and persistent diplopia. The most common surgical approach reported was a preseptal transconjunctival approach (32.0%), followed by the subciliary (27.9%) and postseptal transconjunctival (26.2%) approaches. The most commonly reported implant for orbital reconstruction was titanium (65.4%), followed by Medpor (43.7%) and composite Medpor and titanium (26.4%). The review of the published data showed a consensus among many of the operative indications mentioned, including a large defect size, enophthalmos, clinical entrapment, and persistent diplopia. CONCLUSIONS Oral and maxillofacial surgeons in the United States have a wide range of practice habits in the management of orbital floor fractures. Although the quality of the available evidence is poor, it supports a consistent approach to the management of orbital floor fractures in terms of the indications and surgical approach. The choice of reconstructive material and timing of repair remain more controversial. A clear need exists for improvement in the available data to help guide and set standards of care for the specialties managing orbital floor fractures.
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Affiliation(s)
- Brian J Christensen
- Resident, Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Waleed Zaid
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA.
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28
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Model-based segmentation in orbital volume measurement with cone beam computed tomography and evaluation against current concepts. Int J Comput Assist Radiol Surg 2015; 11:1-9. [DOI: 10.1007/s11548-015-1228-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 05/20/2015] [Indexed: 10/23/2022]
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29
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Virtual surgery simulation in orbital wall reconstruction: Integration of surgical navigation and stereolithographic models. J Craniomaxillofac Surg 2014; 42:2025-34. [DOI: 10.1016/j.jcms.2014.09.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 08/19/2014] [Accepted: 09/25/2014] [Indexed: 11/22/2022] Open
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Magnetic Resonance Imaging: An Accurate, Radiation-Free, Alternative to Computed Tomography for the Primary Imaging and Three-Dimensional Reconstruction of the Bony Orbit. J Oral Maxillofac Surg 2014; 72:611-8. [DOI: 10.1016/j.joms.2013.08.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 08/26/2013] [Accepted: 08/26/2013] [Indexed: 11/30/2022]
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31
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Borumandi F, Gaggl A, Hachleitner J. Anatomic maxillary sinus balloon for orbital floor repair: a preliminary volumetric study. Orbit 2014; 33:318. [PMID: 24568308 DOI: 10.3109/01676830.2014.881402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Farzad Borumandi
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University , Salzburg , Austria
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32
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Calculated CT Volumes of Lacrimal Glands in Normal Caucasian Orbits. Ophthalmic Plast Reconstr Surg 2013; 29:157-9. [DOI: 10.1097/iop.0b013e3182859751] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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33
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Gunarajah DR, Samman N. Biomaterials for repair of orbital floor blowout fractures: a systematic review. J Oral Maxillofac Surg 2013; 71:550-70. [PMID: 23422151 DOI: 10.1016/j.joms.2012.10.029] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Revised: 10/10/2012] [Accepted: 10/22/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the reported use and outcomes of implant materials used for the restoration of post-traumatic orbital floor defects in adults. MATERIALS AND METHODS A systematic search of the English literature was performed in the databases of PubMed, Cochrane Library, and EMBASE. The study selection process was adapted from the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, and 55 articles complied with the study inclusion criteria. The primary outcome measures were diplopia, enophthalmos, graft extrusion/displacement, and infection related to the graft material. The secondary outcome measures were infraorbital paresthesia, orbital dystopia, orbital soft tissue entrapment, and donor-site complications. RESULTS Of 55 articles, 41 (74.5%) evaluated were retrospective case series, 9 (16.4%) were retrospective case-control studies, 3 (5.5%) were controlled trials, and 2 (3.6%) were prospective case series. Autogenous graft materials were predominantly used in 19 studies, alloplastic materials were used in 33 studies, and the remaining 3 articles reported on allogeneic materials. Overall, 19 different types of implant materials were used in 2,483 patients. Of 827 patients with diplopia before surgery, 151 (18.3%) had diplopia postoperatively. Of 449 patients with enophthalmos before surgery, 134 (29.8%) had enophthalmos postoperatively. Only 2 patients (0.1%) and 14 patients (0.6%) had graft extrusion/displacement and infection related to the graft material, respectively; alloplastic biomaterials were used in all of these cases. CONCLUSIONS All graft materials used were successful to variable degrees because all studies reported improvement in terms of the recorded outcome measures. A guideline for choice of implant material based on defect size was developed.
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Strong EB, Fuller SC, Wiley DF, Zumbansen J, Wilson MD, Metzger MC. Preformed vs intraoperative bending of titanium mesh for orbital reconstruction. Otolaryngol Head Neck Surg 2013; 149:60-6. [PMID: 23482478 DOI: 10.1177/0194599813481430] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The most accurate orbital reconstructions result from an anatomic repair of the premorbid orbital architecture. Many different techniques and materials have been used; unfortunately, there is currently no optimal method. This study compares the use of preformed vs intraoperative bending of titanium mesh for orbital reconstruction in 2-wall orbital fractures. STUDY DESIGN Cadaver-based study. SETTING University hospital. SUBJECTS AND METHODS Preinjury computed tomography scans were obtained in 15 cadaveric heads (30 orbits). Stereolithographic (STL) models were fabricated for 5 of the specimens (10 orbits). Two wall fractures (lamina papyracea and floor) were then generated in all orbits. Surgical reconstruction was performed in all orbits using 1 of 3 techniques (10 orbits each): (1) patient-specific implant molded from the preinjury STL model, (2) titanium mesh sheet bent freehand, and (3) preformed titanium mesh. Each technique was evaluated for orbital volume correction, contour accuracy, ease of use, and cost. RESULTS No difference in volume restoration was found between the 3 techniques. Patient-specific implants had the greatest contour accuracy, poor ease of use, and highest cost. Freehand bending implants had the poorest contour accuracy, acceptable ease of use, and lowest cost. Preformed mesh implants had intermediate contour accuracy, excellent ease of use, and low cost. CONCLUSION All 3 techniques provide equivalent orbital volume correction. However, preformed mesh implants have many advantages based on contour accuracy, ease of use, and relative cost.
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Affiliation(s)
- E Bradley Strong
- Department of Otolaryngology, University of California, Davis, California 95817, USA.
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Radiologic and long-term clinical outcome from treatment of isolated medial orbital wall blowout fractures. J Craniofac Surg 2013; 23:1252-5. [PMID: 22948627 DOI: 10.1097/scs.0b013e31825e4e8e] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Blowout fractures in the medial orbital wall may lead to enophthalmos, ocular dysmotility, and diplopia. Ten consecutive patients with unilateral, isolated fractures of the medial orbital wall were retrospectively studied. The radiologic accuracy of the medial orbital wall reconstructions and the long-term clinical outcomes were assessed. All cases were treated through a bicoronal approach and by use of porous polyethylene-titanium implants. The total fracture area and the orbital volume increase from the blowout were measured on computed tomographic scans. Next, we evaluated the reconstruction in the posterior part of the medial wall. This was done by calculating the ratio between the defect area and the implant area located behind the anterior ethmoidal canal. The patients were examined at least 1 year after the operation, and the rates of enophthalmos and diplopia were evaluated. The mean fracture defect area was 2.45 cm2 (range, 0.41-4.16 cm2), and the mean volume increase from the blowout fractures was 1.82 cm3 (range, 0.53-2.76 cm3). The orbital volume was accurately restored in all patients. However, the ratio of implant to defect area behind the anterior ethmoidal canal ranged from 0% to 100% (mean, 47.3%). None of the patients had enophthalmos or diplopia at the long-term follow-up. The results confirm that restoration of orbital volume is important to prevent postoperative enophthalmos in isolated medial orbital blowout fractures. Complete reconstruction of the most posterior part of the medial orbital wall seems to be of lesser importance.
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Quantitative Assessment of Medial Orbit Fracture Repair Using Computer-Designed Anatomical Plates. Plast Reconstr Surg 2012; 130:698e-705e. [DOI: 10.1097/prs.0b013e3182686358] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Markiewicz MR, Dierks EJ, Potter BE, Bell RB. Reliability of Intraoperative Navigation in Restoring Normal Orbital Dimensions. J Oral Maxillofac Surg 2011; 69:2833-40. [DOI: 10.1016/j.joms.2010.12.043] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 11/21/2010] [Accepted: 12/27/2010] [Indexed: 10/18/2022]
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Reconstruction of Severe Medial Orbital Wall Fractures Using Titanium Mesh Plates Placed Using Transcaruncular-Transconjunctival Approach: A Successful Combination of 2 Techniques. J Oral Maxillofac Surg 2011; 69:1415-20. [DOI: 10.1016/j.joms.2010.07.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2010] [Revised: 06/02/2010] [Accepted: 07/03/2010] [Indexed: 11/24/2022]
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Momjian A, Heuberger J, Scolozzi P. [Post-traumatic orbital reconstruction comparing preformed versus non preformed titanium mesh plates]. REVUE DE STOMATOLOGIE ET DE CHIRURGIE MAXILLO-FACIALE 2011; 112:145-50. [PMID: 21497362 DOI: 10.1016/j.stomax.2011.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 01/30/2011] [Accepted: 03/02/2011] [Indexed: 11/27/2022]
Abstract
AIM We compared, clinically and radiologically, the accuracy and reliability of two types of titanium mesh plates used for orbital reconstruction. The first were non-preshaped mesh plates (NPMP) and the second were three-dimensionally preformed mesh plates (PMP). METHODS Two groups were created, each including 15 patients treated with NPMP and the second formed by 15 patients treated with PMP. The volume of each orbit was computed from coronal CT-scans using the OsiriX medical imaging software (version 3.3.2, www.osirix-viewer.com). Measurements were done for both, healthy and reconstructed sides. The other studied parameters were: sex, age, fracture distribution, and complications (diplopia and enophthalmia). RESULTS The orbital volume difference between the reconstructed and the healthy contralateral side was not statistically significant in either group (NPMP: p=0.991 PMP: p=0.200). The mean orbital volume of reconstructed orbits was not statistically significant in either group (NPMP: 21.76 cm(3) and PMP: 20.28 cm(3), p=0.441). DISCUSSION There is no difference in orbital volume reconstructions measured by the OsiriX software between non-preshaped and three-dimensionally preformed titanium mesh plates.
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Affiliation(s)
- A Momjian
- Service de chirurgie maxillofaciale et de chirurgie buccale, département de chirurgie, hôpitaux universitaires de Genève, Geneva, Switzerland.
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40
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Abstract
PURPOSE OF REVIEW Orbital trauma is common and frequently complicated by ocular injuries. The recent literature on orbital fracture is analyzed with emphasis on epidemiological data assessment, surgical timing, method of approach and reconstruction materials. RECENT FINDINGS Computed tomographic (CT) scan has become a routine evaluation tool for orbital trauma, and mobile CT can be applied intraoperatively if necessary. Concomitant serious ocular injury should be carefully evaluated preoperatively. Patients presenting with nonresolving oculocardiac reflex, 'white-eyed' blowout fracture, or diplopia with a positive forced duction test and CT evidence of orbital tissue entrapment require early surgical repair. Otherwise, enophthalmos can be corrected by late surgery with a similar outcome to early surgery. The use of an endoscope-assisted approach for orbital reconstruction continues to grow, offering an alternative method. Advances in alloplastic materials have improved surgical outcome and shortened operating time. SUMMARY In this review of modern orbital reconstruction, several controversial issues such as surgical indication, surgical timing, method of approach and choice of reconstruction material are discussed. Preoperative fine-cut CT image and thorough ophthalmologic examination are key elements to determine surgical indications. The choice of surgical approach and reconstruction materials much depends on the surgeon's experience and the reconstruction area. Prefabricated alloplastic implants together with image software and stereolithographic models are significant advances that help to more accurately reconstruct the traumatized orbit. The recent evolution of orbit reconstruction improves functional and aesthetic results and minimizes surgical complications.
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Computer-Aided Volumetric Comparison of Reconstructed Orbits for Blow-Out Fractures With Nonpreformed Versus 3-Dimensionally Preformed Titanium Mesh Plates. J Comput Assist Tomogr 2010; 34:98-104. [DOI: 10.1097/rct.0b013e3181ac1975] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Levy JM, Hasney CP, Friedlander PL, Kandil E, Occhipinti EA, Kahn MJ. Combined mycophenolate mofetil and prednisone therapy in tamoxifen- and prednisone-resistant Reidel's thyroiditis. Thyroid 2010; 20:105-7. [PMID: 20067381 DOI: 10.1089/thy.2009.0324] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mycophenolate mofetil is a recently identified therapy for disorders associated with systemic fibrosis, but has never been reported in the treatment of Reidel's thyroiditis. We report the first case of Reidel's thyroiditis that became resectable after treatment with mycophenolate and prednisone. SUMMARY A 27-year-old woman presented to an outside hospital with thyromegaly associated with compressive symptoms. The patient underwent a neck exploration with thyroid biopsy that revealed evidence of fibrosing variant Hashimoto's thyroiditis. The patient was then treated with tamoxifen and prednisone at an outside hospital without resolution. After initial evaluation she underwent an open thyroid wedge biopsy that revealed Reidel's thyroiditis. She was subsequently treated with both 1 g mycophenolate twice daily and 100 mg prednisone daily. The patient experienced immediate subjective improvement of compressive symptoms and objective decrease in mass size at 30 days, as seen by serial computed tomography examination. By 90 days of therapy the mass had decreased to a size small enough to allow subtotal thyroidectomy, which was completed over two staged procedures. CONCLUSIONS Reidel's thyroiditis remains a primarily surgical disease. Patients who are not surgical candidates have been treated with tamoxifen and prednisone with equivocal results. Our report is the first to suggest the combination of mycophenolate and prednisone as a viable treatment option for patients with Reidel's thyroiditis.
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Affiliation(s)
- Joshua M Levy
- Department of Otorhinolaryngology, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA
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Accuracy and Predictability in Use of AO Three-Dimensionally Preformed Titanium Mesh Plates for Posttraumatic Orbital Reconstruction. J Craniofac Surg 2009; 20:1108-13. [DOI: 10.1097/scs.0b013e3181abb44b] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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