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Three-Dimensional Reconstruction of Orbital Fractures
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Orbital Wall Reconstruction with Two-Piece Puzzle 3D Printed Implants: Technical Note.

Maurice Y Mommaerts1, Michael Büttner2, Herman Vercruysse2

  • 1European Face Centre, Universitair Ziekenhuis Brussel, VUB, Brussels, Belgium; Orthoface Clinic, Oost-Vlaanderen, Belgium.

Craniomaxillofacial Trauma & Reconstruction
|February 19, 2016
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Summary

This study introduces a novel 3D-printed titanium implant technique for reconstructing complex orbital wall defects. The method achieved near-complete restoration of orbital volume and eye movement in three patients.

Keywords:
computer-assistedorbital fracturesprintingsurgerythree-dimensional

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Area of Science:

  • Biomedical Engineering
  • Ophthalmology
  • Plastic Surgery

Background:

  • Traumatic orbital wall defects often require complex reconstruction.
  • Secondary reconstruction presents unique challenges due to tissue damage and scarring.

Purpose of the Study:

  • To describe a novel technique for secondary reconstruction of traumatic orbital wall defects.
  • To evaluate the efficacy of 3D-printed titanium implants as "puzzle pieces" for orbital reconstruction.

Main Methods:

  • Utilized custom-designed 3D-printed titanium implants (Xilloc Medical B.V., LayerWise) for orbital reconstruction.
  • Employed biomedical engineering software (ProPlan, 3-Matic) for implant design.
  • Performed sequential implantation through a limited transconjunctival incision for extensive defects.
  • Confirmed implant fit using intraoperative 3D imaging (Philips Medical Systems).

Main Results:

  • Successfully reconstructed large, extensive two-wall orbital defects in three patients.
  • Achieved near-complete restoration of orbital volume and ocular motility.
  • Demonstrated precise implant fit with surrounding bone structures and adjacent implants.

Conclusions:

  • 3D-printed titanium implants offer a precise and effective solution for secondary reconstruction of complex orbital wall defects.
  • The "puzzle piece" approach allows for sequential implantation and restoration of orbital function.
  • Challenges such as traumatic fat atrophy and fibrosis require further consideration.