BACKGROUND: Correction of post-traumatic orbital defects remains a challenge for the maxillofacial surgeon. We examined the added value of combined intraoperative (IO) navigation and IO cone beam computed tomography (CBCT). MATERIALS AND METHODS: A retrospective cohort study was performed in all consecutive patients requiring unilateral post-traumatic orbital surgery between January 2012 and December 2018. Patients were divided into 3 groups: IO navigation (NAV), IO-CBCT (CBCT), and IO navigation with IO-CBCT (NAV-CBCT). A detailed description of our workflow is provided. Volumetric comparison of the operated orbit to the contralateral orbit was made with Brainlab. RESULTS: Of the 81 cases, 22 patients were included (12 males/10 females) with a mean age of 51 years. Three patients were assigned to NAV, 6 to CBCT, and 13 to NAV-CBCT. The reconstructed orbital volume did not significantly differ from the contralateral orbital volume within the 3 groups. The mean difference between the contralateral and the operated orbit was 3.05 cm3, 3.72 cm3, and 1.47 cm3 for NAV, CBCT, and NAV-CBCT, respectively, where only NAV-CBCT showed a significant smaller volumetric difference in comparison to CBCT alone. Gender or age did not correlate with difference in orbital volume. Normal function and aesthetics was seen at 6 weeks postoperative in 0 of 3, 6of 6, and 6 of 13 patients of the NAV, CBCT, and NAV-CBCT, respectively. CONCLUSION: Orbital defects can be treated effectively using IO navigation. Although our data could not demonstrate a significant added value of IO-CBCT in cases where IO navigation was used based on volumetric difference alone, the combination of IO-CBCT and IO navigation seems to give the best results considering both volumetric difference and postoperative function and aesthetics. Confirmation in a prospective, randomized trial with a larger sample size is required.
BACKGROUND: Correction of post-traumatic orbital defects remains a challenge for the maxillofacial surgeon. We examined the added value of combined intraoperative (IO) navigation and IO cone beam computed tomography (CBCT). MATERIALS AND METHODS: A retrospective cohort study was performed in all consecutive patients requiring unilateral post-traumatic orbital surgery between January 2012 and December 2018. Patients were divided into 3 groups: IO navigation (NAV), IO-CBCT (CBCT), and IO navigation with IO-CBCT (NAV-CBCT). A detailed description of our workflow is provided. Volumetric comparison of the operated orbit to the contralateral orbit was made with Brainlab. RESULTS: Of the 81 cases, 22 patients were included (12 males/10 females) with a mean age of 51 years. Three patients were assigned to NAV, 6 to CBCT, and 13 to NAV-CBCT. The reconstructed orbital volume did not significantly differ from the contralateral orbital volume within the 3 groups. The mean difference between the contralateral and the operated orbit was 3.05 cm3, 3.72 cm3, and 1.47 cm3 for NAV, CBCT, and NAV-CBCT, respectively, where only NAV-CBCT showed a significant smaller volumetric difference in comparison to CBCT alone. Gender or age did not correlate with difference in orbital volume. Normal function and aesthetics was seen at 6 weeks postoperative in 0 of 3, 6of 6, and 6 of 13 patients of the NAV, CBCT, and NAV-CBCT, respectively. CONCLUSION: Orbital defects can be treated effectively using IO navigation. Although our data could not demonstrate a significant added value of IO-CBCT in cases where IO navigation was used based on volumetric difference alone, the combination of IO-CBCT and IO navigation seems to give the best results considering both volumetric difference and postoperative function and aesthetics. Confirmation in a prospective, randomized trial with a larger sample size is required.
Authors: Philippe Boeckx; Harald Essig; Horst Kokemuller; Frank Tavassol; Nils Claudius Gellrich; Gwen R J Swennen Journal: J Oral Maxillofac Surg Date: 2015-04-03 Impact factor: 1.895
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Authors: M C Metzger; R Schön; R Tetzlaf; N Weyer; A Rafii; N-C Gellrich; R Schmelzeisen Journal: Int J Oral Maxillofac Surg Date: 2006-12-20 Impact factor: 2.789
Authors: Rüdiger M Zimmerer; Edward Ellis; Gregorio Sanchez Aniceto; Alexander Schramm; Maximilian E H Wagner; Michael P Grant; Carl-Peter Cornelius; Edward Bradley Strong; Majeed Rana; Lim Thiam Chye; Alvaro Rivero Calle; Frank Wilde; Daniel Perez; Frank Tavassol; Gido Bittermann; Nicholas R Mahoney; Marta Redondo Alamillos; Joanna Bašić; Jan Dittmann; Michael Rasse; Nils-Claudius Gellrich Journal: J Craniomaxillofac Surg Date: 2016-07-21 Impact factor: 2.078
Authors: Harald Essig; Lars Dressel; Majeed Rana; Madiha Rana; Horst Kokemueller; Martin Ruecker; Nils-Claudius Gellrich Journal: Head Face Med Date: 2013-07-02 Impact factor: 2.151