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Updated: Apr 1, 2026
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Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
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Predictability in orbital reconstruction. A human cadaver study, part III: Implant-oriented navigation for optimized
Leander Dubois1, Harald Essig2, Ruud Schreurs3
1Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. J. de Lange), Orbital Unit, Academic Medical Centre of Amsterdam, University of Amsterdam, Academic Centre for Dentistry (ACTA), Meibergdreef 9, 1105 AZ Amsterdam ZO, The Netherlands.
Summary
Adding navigation markers to orbital implants improves surgical accuracy for complex orbital reconstructions. This technique enhances three-dimensional (3D) orientation, leading to more reliable and consistent patient outcomes in orbital fracture repair.
Area of Science:
- Neurosurgery
- Medical Imaging
- Biomedical Engineering
Background:
- Orbital reconstruction surgery presents challenges in achieving precise implant positioning due to reliance on 2D views.
- Current navigation-assisted techniques can be limited in providing accurate 3D orientation of implants relative to preoperative plans.
Purpose of the Study:
- To evaluate the efficacy of incorporating navigation markers directly into orbital implant designs.
- To enhance the accuracy and consistency of three-dimensional (3D) implant orientation during navigation-assisted orbital reconstruction.
Main Methods:
- Complex orbital fractures (Class III/IV) were created in 10 human cadaver orbits.
- Reconstruction was performed using preformed orbital mesh under image-guided navigation.
- Implant placement accuracy was assessed using preoperative computed tomography (CT) planning and comparing it to the realized implant position, with and without implant-oriented navigation markers.
Main Results:
- Implant-oriented navigation significantly improved translational accuracy (1.44 mm vs. 3.53 mm) and rotational accuracy in yaw (5.9° vs. 10.9°).
- The study demonstrated enhanced accuracy in positioning the implant relative to the planned trajectory.
- Navigation markers on implants facilitated more fail-safe and consistent reconstruction of complex orbital defects.
Conclusions:
- Integrating navigation markers into orbital implant design significantly improves the accuracy of navigation-assisted orbital reconstruction.
- This approach offers a more reliable method for achieving precise 3D orientation and positioning of implants.
- The findings suggest a pathway to more consistent and successful surgical outcomes for complex orbital reconstructions.
