Rüdiger M Zimmerer1, Edward Ellis2, Gregorio Sanchez Aniceto3, Alexander Schramm4, Maximilian E H Wagner5, Michael P Grant6, Carl-Peter Cornelius7, Edward Bradley Strong8, Majeed Rana5, Lim Thiam Chye9, Alvaro Rivero Calle3, Frank Wilde4, Daniel Perez2, Frank Tavassol5, Gido Bittermann10, Nicholas R Mahoney6, Marta Redondo Alamillos3, Joanna Bašić4, Jan Dittmann5, Michael Rasse11, Nils-Claudius Gellrich5. 1. Medizinische Hochschule Hannover, Mund-, Kiefer- und Gesichtschirurgie, Carl-Neubergstr. 1, 30625, Hannover, Germany. Electronic address: Zimmerer.Ruediger@mh-hannover.de. 2. University of Texas Health Science Center, Department of Oral and Maxillofacial Surgery, 7703 Floyd Curl Dr., San Antonio, TX, 78229, USA. 3. 12 de Octubre University Hospital, Cirurgia Maxillofacial, Av. De Cordoba s/n, 28041, Madrid, Spain. 4. Bundeswehrkrankenhauses Ulm, Department of Oral, Maxillofacial and Plastic Facial Surgery, Oberer Eselsberg 40, 89081, Ulm, Germany. 5. Medizinische Hochschule Hannover, Mund-, Kiefer- und Gesichtschirurgie, Carl-Neubergstr. 1, 30625, Hannover, Germany. 6. Johns Hopkins Hospital, Wilmer Eye Institute, 600 North Wolfe Street, Baltimore, MD, 21287, USA. 7. Klinikum der LMU Muenchen, Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Lindwurmstr. 2a, 80337, München, Germany. 8. University of California Davis, Department of Otolaryngology-Head and Neck Surgery, 2521 Stockton Blvd., Suite 7200, Sacramento, 95817, CA, USA. 9. National University Hospital, Division of Plastic Surgery, Lower Kent Ridge Road, 119074, Singapore, Singapore. 10. Albert-Ludwigs-Universität, Mund-, Kiefer- und Gesichtschirurgie, Hugstetter Straße 55, 79106, Freiburg i.Br., Germany. 11. Medizinische Universitätsklinik Innsbruck, Universitätsklinik für Mund-, Kiefer- und Gesichtschirurgie, Zahn-, Mund- und Kieferheilkunde, Anichstrasse 35, 6020, Innsbruck, Austria.
Abstract
PURPOSE: A variety of implants are available for orbital reconstruction. Titanium orbital mesh plates are available either as standard preformed implants or able to be individualized for the patient. The aim of this study was to analyze whether individualized orbital implants allow a more precise reconstruction of the orbit than standard preformed implants. MATERIALS AND METHODS: A total of 195 patients treated between 2010 and 2014 were followed up to 12 weeks after surgery. Of the patients, 100 had received standardized preformed and 95 individualized implants. The precision of orbital reconstruction with the different implants was determined by comparing the variances in the volume difference between the reconstructed and the contralateral orbit on the postoperative computed tomographic scans. Clinical volume-related parameters including globe position, vision, motility, and diplopia and surgical details including approach, timing and technique of implant modification, use of navigation, duration of surgery, as well as adverse events were documented. RESULTS: Orbital reconstruction was significantly more precise when individualized implants were used. The same was seen with intraoperative navigation. An overlap in the use of individualized implants and navigation makes it difficult to attribute the improved precision to a single factor. CONCLUSION: This study demonstrated that individualization and navigation provide clinical benefit.
PURPOSE: A variety of implants are available for orbital reconstruction. Titanium orbital mesh plates are available either as standard preformed implants or able to be individualized for the patient. The aim of this study was to analyze whether individualized orbital implants allow a more precise reconstruction of the orbit than standard preformed implants. MATERIALS AND METHODS: A total of 195 patients treated between 2010 and 2014 were followed up to 12 weeks after surgery. Of the patients, 100 had received standardized preformed and 95 individualized implants. The precision of orbital reconstruction with the different implants was determined by comparing the variances in the volume difference between the reconstructed and the contralateral orbit on the postoperative computed tomographic scans. Clinical volume-related parameters including globe position, vision, motility, and diplopia and surgical details including approach, timing and technique of implant modification, use of navigation, duration of surgery, as well as adverse events were documented. RESULTS: Orbital reconstruction was significantly more precise when individualized implants were used. The same was seen with intraoperative navigation. An overlap in the use of individualized implants and navigation makes it difficult to attribute the improved precision to a single factor. CONCLUSION: This study demonstrated that individualization and navigation provide clinical benefit.
Authors: Nils-Claudius Gellrich; Jan Dittmann; Simon Spalthoff; Philipp Jehn; Frank Tavassol; Rüdiger Zimmerer Journal: J Maxillofac Oral Surg Date: 2019-06-12
Authors: Lukas Goertz; Pantelis Stavrinou; George Stranjalis; Marco Timmer; Roland Goldbrunner; Boris Krischek Journal: J Neurol Surg B Skull Base Date: 2019-03-01