Sabelis Juliana F, Schreurs Ruud, Essig Harald, Becking Alfred G, Dubois Leander
Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centre (UMC), AMC, Academic Center for Dentistry Amsterdam (ACTA), Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre Nijmegen, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands.
J Pers Med. 2022 Aug 24;12(9):1366. doi: 10.3390/jpm12091366.
Restoration of the orbit is the first and most predictable step in the surgical treatment of orbital fractures. Orbital reconstruction is keyhole surgery performed in a confined space. A technology-supported workflow called computer-assisted surgery (CAS) has become the standard for complex orbital traumatology in many hospitals. CAS technology has catalyzed the incorporation of personalized medicine in orbital reconstruction. The complete workflow consists of diagnostics, planning, surgery and evaluation. Advanced diagnostics and virtual surgical planning are techniques utilized in the preoperative phase to optimally prepare for surgery and adapt the treatment to the patient. Further personalization of the treatment is possible if reconstruction is performed with a patient-specific implant and several design options are available to tailor the implant to individual needs. Intraoperatively, visual appraisal is used to assess the obtained implant position. Surgical navigation, intraoperative imaging, and specific PSI design options are able to enhance feedback in the CAS workflow. Evaluation of the surgical result can be performed both qualitatively and quantitatively. Throughout the entire workflow, the concepts of CAS and personalized medicine are intertwined. A combination of the techniques may be applied in order to achieve the most optimal clinical outcome. The goal of this article is to provide a complete overview of the workflow for post-traumatic orbital reconstruction, with an in-depth description of the available personalization and CAS options.
眼眶修复是眼眶骨折手术治疗的首要且最具可预测性的步骤。眼眶重建是在有限空间内进行的微创手术。一种名为计算机辅助手术（CAS）的技术支持工作流程已成为许多医院复杂眼眶创伤学的标准。CAS技术推动了个性化医疗在眼眶重建中的应用。完整的工作流程包括诊断、规划、手术和评估。先进的诊断和虚拟手术规划是术前阶段采用的技术，用于为手术做好最佳准备并使治疗适应患者。如果使用定制植入物进行重建且有多种设计选项可根据个体需求定制植入物，则治疗可进一步个性化。术中，通过视觉评估来确定植入物的位置。手术导航、术中成像和特定的PSI设计选项能够增强CAS工作流程中的反馈。手术结果的评估可以定性和定量方式进行。在整个工作流程中，CAS和个性化医疗的概念相互交织。为实现最佳临床效果，可综合应用这些技术。本文旨在全面概述创伤后眼眶重建的工作流程，并深入描述可用的个性化和CAS选项。
