Patient-Specific Implant Customization for Treatment of Internal Orbital Fractures Using Office-Based...

Area of Science:

• Biomedical Engineering
• Plastic and Reconstructive Surgery
• Medical Imaging

Background:

• Three-dimensional (3D) modeling and printing are increasingly utilized in reconstructive surgery.
• Traditionally, 3D modeling and printing services for custom implants were outsourced.
• Incorporating these technologies into clinical practice offers potential for improved workflow and cost-efficiency.

Purpose of the Study:

• To present a standardized, low-cost, office-based workflow for restoring bony orbital volume in traumatic orbital fractures using 3D printing.
• To evaluate the efficiency and cost-effectiveness of an in-house 3D printing approach for custom orbital implants.

Main Methods:

• Patients with internal orbital fractures underwent open repair.
• Virtual 3D models were created using specialized software (iPlan 3.0 Cranial CMF).
• Office-based 3D printing was used to fabricate and modify orbital plates for precise fracture defect fitting. Postoperative CT scans and software were used for accuracy assessment.

Main Results:

• Nine patients (8 unilateral, 1 bilateral fractures) were included.
• Average image processing and printing times were 1.5 and 3 hours, respectively.
• The system cost $2500, with an average material cost of $2 per orbital model. Postoperative orbital volume differences were minimal (-0.2 ± 0.4 mL).

Conclusions:

• Office-based 3D printing is a viable, efficient, and cost-effective method for repairing internal orbital fractures.
• This workflow allows for the routine design of patient-specific implants with satisfactory clinical outcomes.
• The technology facilitates improved reconstructive surgery planning and execution in craniomaxillofacial practices.