Navigation-guided orbital medial wall fracture reconstruction.

Area of Science:

• Ophthalmology
• Neurosurgery
• Medical Imaging

Background:

• Medial orbital wall fractures are common and challenging to diagnose with conventional radiography.
• Fracture extension poses risks of optic nerve compression.
• A combined transethmoidal and transcaruncular approach was previously introduced for these fractures.

Purpose of the Study:

• To evaluate the efficacy of surgical navigation in enhancing precision, safety, and anatomical reconstruction for medial orbital wall fractures.
• To compare postoperative functional and anatomical outcomes with and without intraoperative navigation.
• To assess the minimization of complications using surgical navigation.

Main Methods:

• 48 patients with isolated medial wall fractures were treated using a combined transcaruncular approach and transethmoidal packing.
• 23 patients underwent surgery with intraoperative navigation; 25 did not.
• Outcomes were assessed via ophthalmologic evaluations, Hertel exophthalmometry, and CT-based orbital volume measurements.

Main Results:

• Surgical navigation was successfully implemented in all cases.
• Postoperative recovery was complete with no residual symptoms or complications.
• Orbital volume significantly reduced postoperatively (109.03% to 104.80%, p<0.001), while Hertel scale changes were not significant (p=0.086).

Conclusions:

• Intraoperative navigation enhances precision in medial orbital wall fracture surgery.
• The use of navigation minimizes postoperative complications.
• Surgical navigation is a valuable tool for managing medial orbital fractures.