Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Sep;20(3):459-463.
doi: 10.1007/s12663-020-01423-x. Epub 2020 Jul 18.

Technological Integration of Virtual Surgical Planning, Surgical Navigation, Endoscopic Support and Patient-Specific Implant in Orbital Trauma

Luis Vicente Gonzalez  1 , Alejandro Arango  2 , Juan Pablo López  3   4 , Juan Pablo Gnecco  1
Affiliations
Case Reports

Technological Integration of Virtual Surgical Planning, Surgical Navigation, Endoscopic Support and Patient-Specific Implant in Orbital Trauma

Luis Vicente Gonzalez et al. J Maxillofac Oral Surg. 2021 Sep.

Abstract

Currently, we have different technologies and techniques that improve the results in orbital trauma. However, there are few studies that study the technological integration in orbital trauma and the synergism of all the techniques. For this reason, the objective of this case is to illustrate the management of orbital trauma by integrating endoscopic support, virtual surgical navigation, patient-specific implant, virtual surgical planning in the management of a sequel due to insufficient reconstruction of orbital volume.

Keywords: Endoscopic support; Orbital trauma; Patient-specific implant; Virtual surgical navigation; Virtual surgical planning.

PubMed Disclaimer

Conflict of interest statement

Conflict of interestThe authors have expressed no conflict of interest.

Figures

Fig. 1
Fig. 1
Mirror image, sagittal section. Yellow arrow shows the orbital floor of the unaffected side, overlapping on the affected left orbit; blue arrow shows titanium mesh used on the fractured side from initial surgical procedure (position difference). A. Volumetric reconstruction of the orbit (yellow areas and cone)
Fig. 2
Fig. 2
Virtual planning allows us to design and fabricate an implant with the correct position of the orbital floor. a PEEK Orbital Floor Implant. 3D printed model with implant guide
Fig. 3
Fig. 3
Integration of the endoscope in the navigation flow Arrow: Instrument adapter with clamp and reference star with the three spheres
Fig. 4
Fig. 4
The real-time navigation module allows to improve the location of the implant of the floor of the left orbit, interacting with the virtual planning. Blue star: The lower posterior portion of the PEEK implant. Yellow arrow: posterior portions of the floor of the left orbit. Evaluating the anatomical posterior boundaries
Fig. 5
Fig. 5
Presurgical enophthalmos with 2.8 mm. Correction of the enophthalmos now resulting in 0.3 mm
Fig. 6
Fig. 6
Slices of the CT scan with the correction of the orbital floor. 3D image with 26.8 cm3 postoperative orbital volume
See this image and copyright information in PMC

References

    1. Liss J, Stefko ST, Chung WL. Orbital surgery: state of the art. Oral Maxillofac Surg Clin North Am. 2010;22:59–71. doi: 10.1016/j.coms.2009.11.006. - DOI - PubMed
    1. Walter WL. Early surgical repair of blowout fracture of the orbital floor by using the transantral approach. South Med J. 1972;65:1229–1243. doi: 10.1097/00007611-197210000-00014. - DOI - PubMed
    1. Ikeda K, Suzuki H, Oshima T, Takasaka T. Endoscopic endonasal repair of orbital floor fracture. Arch Otolaryngol Head Neck Surg. 1999;125:59–63. doi: 10.1001/archotol.125.1.59. - DOI - PubMed
    1. Jansen J, Schreurs R, Dubois L, Maal TJJ, Gooris PJJ, Becking AG. The advantages of advanced computer-assisted diagnostics and three-dimensional preoperative planning on implant position in orbital reconstruction. J Craniomaxillofac Surg. 2018;46:715–721. doi: 10.1016/j.jcms.2018.02.010. - DOI - PubMed
    1. Watzinger F, Wanschitz F, Wagner A, Enislidis G, Millesi W, Baumann A, Ewers R. Computer-aided navigation in secondary reconstruction of post-traumatic deformities of the zygoma. J Craniomaxillofac Surg. 1997;25:198–202. doi: 10.1016/S1010-5182(97)80076-5. - DOI - PubMed

Publication types