Intraoperative Computed Tomography Scan for Orbital Fracture Reconstruction

Area of Science:

• Ophthalmology
• Plastic Surgery
• Medical Imaging

Background:

• Orbital fractures present surgical challenges, particularly in achieving accurate orbital implant positioning.
• Traditional methods may lack real-time feedback for precise reconstruction.

Purpose of the Study:

• To evaluate the early application of intraoperative computed tomography (CT) in managing orbital fractures.
• To assess the impact of intraoperative CT on revision rates and surgical outcomes.

Main Methods:

• Utilized pre-surgical planning, optical intraoperative navigation, and intraoperative CT for 5 cases (14 orbital wall fractures).
• Included pure orbital blowout and impure orbitozygomaticomaxillary complex fractures.
• Analyzed revision types and rates associated with the intraoperative CT technique.

Main Results:

• Intraoperative CT led to implant revision in 40% of patients (2/5) and 14% of fractures (2/14) for optimal positioning, especially at the posterior ledge.
• Confirmed accurate reconstruction of medial, inferior walls, and the transition zone.
• Eliminated the need for postoperative imaging in all cases.

Conclusions:

• Intraoperative CT provides real-time assessment for immediate orbital implant revision, enhancing surgical precision.
• This technology simplifies the management of complex orbital fractures.
• Further long-term follow-up studies are recommended for patients treated with intraoperative CT.