Metzger Marc Christian, Schön Ralf, Zizelmann Christoph, Weyer Nils, Gutwald Ralf, Schmelzeisen Rainer
Department of Craniomaxillofacial Surgery, University Freiburg, Freiburg, Germany.
Plast Reconstr Surg. 2007 Mar;119(3):969-76. doi: 10.1097/01.prs.0000242495.97162.4b.
Three-dimensional reconstruction of the orbital floor is a key procedure in primary or secondary orbital deformity. A new procedure for individually bending and preforming implants preoperatively for the reconstruction of orbital fractures is presented.
By using diagnostic computed tomographic scan data, the topography of the orbital floor and wall structures can be recalculated. After mirroring the unaffected side onto the affected side, the defect can be reconstructed virtually. Data of the individual virtual model of the orbital cavity are sent to a template machine that reproduces the surface of the orbital floor and medial walls automatically. A titanium mesh can then be adjusted preoperatively for exact three-dimensional reconstruction. Twelve patients with orbital fractures were treated using individually preformed titanium implants.
All patients treated with this procedure showed normal eye mobility and function after primary reconstruction. The accuracy of the preformed implants lies in the range of 1 mm.
This procedure offers an individual anatomical reconstruction of the orbital cavity true to original, especially when the deep orbital cone is affected. Navigation-aided procedures guarantee intraoperatively an exact placement of the preformed mesh even for precise reconstruction of extensive orbital defects.
眼眶底的三维重建是原发性或继发性眼眶畸形治疗中的关键步骤。本文介绍一种术前对植入物进行个体化弯曲和预制以重建眼眶骨折的新方法。
利用诊断性计算机断层扫描数据，可重新计算眼眶底和眶壁结构的地形。将未受影响侧镜像到受影响侧后，可对缺损进行虚拟重建。眼眶腔个体虚拟模型的数据被发送到一台模板机，该机器可自动复制眼眶底和内侧壁的表面。然后可在术前对钛网进行调整，以实现精确的三维重建。12例眼眶骨折患者接受了个体化预制钛植入物治疗。
所有接受该手术治疗的患者在初次重建后均表现出正常的眼球活动度和功能。预制植入物的精度在1毫米范围内。
该方法能对眼眶腔进行符合原始解剖结构的个体化重建，尤其是在深部眼眶圆锥受影响时。导航辅助手术可在术中确保预制网片的精确放置，即使是对广泛眼眶缺损的精确重建。
