OBJECTIVE: Enophthalmos is a severe complication of primary reconstruction of orbital floor fractures. The goal of secondary reconstruction procedures is to restore symmetrical globe positions to recover function and aesthetics. The authors propose a new method of orbital floor reconstruction using a mirroring technique and a customized titanium mesh, printed using a direct metal laser-sintering method. METHODS: This reconstructive protocol involves 4 steps: mirroring of the healthy orbit at the affected site, virtual design of a patient-specific orbital floor mesh, CAM procedures for direct laser-sintering of the customized titanium mesh, and surgical insertion of the device. Using a computed tomography data set, the normal, uninjured side of the craniofacial skeleton was reflected onto the contralateral injured side, and a reconstructive orbital floor mesh was designed virtually on the mirrored orbital bone surface. The solid-to-layer files of the mesh were then manufactured using direct metal laser sintering, which resolves the shaping and bending biases inherent in the indirect method. An intraoperative navigation system ensured accuracy of the entire procedure. RESULTS: Clinical outcomes were assessed using 3dMD photogrammetry and computed tomography data in 7 treated patients. CONCLUSION: The technique described here appears to be a viable method to correct complex orbital floor defects needing delayed reconstruction. This study represents the first step in the development of a wider experimental protocol for orbital floor reconstruction using computer-assisted design-computer-assisted manufacturing technology. PMID: 27438454 DOI: 10.1097/SCS.0000000000002907

ORBITAL RECONSTRUCTION: PATIENT-SPECIFIC ORBITAL FLOOR RECONSTRUCTION USING A MIRRORING TECHNIQUE AND A CUSTOMIZED TITANIUM MESH / Tarsitano, Achille; Badiali, Giovanni; Pizzigallo, Angelo; Marchetti, Claudio. - In: THE JOURNAL OF CRANIOFACIAL SURGERY. - ISSN 1049-2275. - STAMPA. - 27:7(2016), pp. 1822-1825. [10.1097/SCS.0000000000002907]

ORBITAL RECONSTRUCTION: PATIENT-SPECIFIC ORBITAL FLOOR RECONSTRUCTION USING A MIRRORING TECHNIQUE AND A CUSTOMIZED TITANIUM MESH.

TARSITANO, ACHILLE;BADIALI, GIOVANNI;PIZZIGALLO, ANGELO;MARCHETTI, CLAUDIO
2016

Abstract

OBJECTIVE: Enophthalmos is a severe complication of primary reconstruction of orbital floor fractures. The goal of secondary reconstruction procedures is to restore symmetrical globe positions to recover function and aesthetics. The authors propose a new method of orbital floor reconstruction using a mirroring technique and a customized titanium mesh, printed using a direct metal laser-sintering method. METHODS: This reconstructive protocol involves 4 steps: mirroring of the healthy orbit at the affected site, virtual design of a patient-specific orbital floor mesh, CAM procedures for direct laser-sintering of the customized titanium mesh, and surgical insertion of the device. Using a computed tomography data set, the normal, uninjured side of the craniofacial skeleton was reflected onto the contralateral injured side, and a reconstructive orbital floor mesh was designed virtually on the mirrored orbital bone surface. The solid-to-layer files of the mesh were then manufactured using direct metal laser sintering, which resolves the shaping and bending biases inherent in the indirect method. An intraoperative navigation system ensured accuracy of the entire procedure. RESULTS: Clinical outcomes were assessed using 3dMD photogrammetry and computed tomography data in 7 treated patients. CONCLUSION: The technique described here appears to be a viable method to correct complex orbital floor defects needing delayed reconstruction. This study represents the first step in the development of a wider experimental protocol for orbital floor reconstruction using computer-assisted design-computer-assisted manufacturing technology. PMID: 27438454 DOI: 10.1097/SCS.0000000000002907
2016
ORBITAL RECONSTRUCTION: PATIENT-SPECIFIC ORBITAL FLOOR RECONSTRUCTION USING A MIRRORING TECHNIQUE AND A CUSTOMIZED TITANIUM MESH / Tarsitano, Achille; Badiali, Giovanni; Pizzigallo, Angelo; Marchetti, Claudio. - In: THE JOURNAL OF CRANIOFACIAL SURGERY. - ISSN 1049-2275. - STAMPA. - 27:7(2016), pp. 1822-1825. [10.1097/SCS.0000000000002907]
Tarsitano, Achille; Badiali, Giovanni; Pizzigallo, Angelo; Marchetti, Claudio
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/586382
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