Three Dimensional-guided Surgical Treatment of a Posttraumatic Enophthalmos: Advantages of the Technique and...

This case report described posttraumatic enophthalmos treated with 3-dimensional (3D)-guided piezosurgery to highlight the advantages of this less-invasive technique coupled with morphometric analysis. A 29-year-old patient presented with posttraumatic enophthalmos following a previous surgery involving reduction and osteosynthesis of a right zygomatico-orbito-malar complex fracture, caused by motorcycle trauma. Virtual surgical planning and 3D printing were used for right orbital reconstruction. Osteotomy of the right orbit was performed using piezosurgery along the inferior orbital rim and the right zygomatic arch. The gap in the right zygomatic region was filled with an iliac crest bone graft. Comparison of pre- and postoperative computed tomography images revealed that the size of the right orbit decreased by 8 mm in the lateral-medial direction, whereas the volume decreased by 6%. The patient did not report diplopia, and extrinsic eye movements were preserved. We did not observe sensitivity variation in the innervation territory of the right infraorbital nerve. We concluded that the combination of virtual surgical planning, 3D printing, and piezosurgery enhances the treatment of posttraumatic enophthalmos.