Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지
DOI QR코드

DOI QR Code

Late reconstruction of extensive orbital floor fracture with a patient-specific implant in a bombing victim

  • Smeets, Maximiliaan (OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine) ;
  • Snel, Robin (OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine) ;
  • Sun, Yi (OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine) ;
  • Dormaar, Titiaan (OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine) ;
  • Politis, Constantinus (OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine)
  • Received : 2018.07.13
  • Accepted : 2018.08.31
  • Published : 2020.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Fractures of the orbital floor and walls are among the most frequent maxillofacial fractures. Virtual three-dimensional (3D) planning and use of patient-specific implants (PSIs) could improve anatomic and functional outcomes in orbital reconstruction surgery. The presented case was a victim of a terrorist attack involving improvised explosive devices. This 58-year-old female suffered severe wounds caused by a single piece of metal from a bomb, shattering the left orbital floor and lateral orbital wall. Due to remaining hypotropia of the left eye compared to the right eye, late orbital floor reconstruction was carried out with a personalised 3D printed titanium implant. We concluded that this technique with PSI appears to be a viable method to correct complex orbital floor defects. Our research group noted good aesthetic and functional results one year after surgery. Due to the complexity of the surgery for a major bony defect of the orbital floor, it is important that the surgery be executed by experienced surgeons in the field of maxillofacial traumatology.

Keywords

References

  1. Ellis E 3rd, Messo E. Use of nonresorbable alloplastic implants for internal orbital reconstruction. J Oral Maxillofac Surg 2004;62:873-81. https://doi.org/10.1016/j.joms.2003.12.025
  2. Bertol LS, Kindlein W Jr, da Silva FP, Aumund-Kopp C. Medical design: direct metal laser sintering of Ti-6Al-4V. Mater Des 2010;31:3982-8. https://doi.org/10.1016/j.matdes.2010.02.050
  3. de Oliveira FM, Salazar-Gamarra R, Ohman D, Nannmark U, Pecorari V, Dib LL. Quality of life assessment of patients utilizing orbital implant-supported prostheses. Clin Implant Dent Relat Res 2018;20:438-43. https://doi.org/10.1111/cid.12602
  4. Davies JC, Chan HHL, Bernstein JM, Goldstein DP, Irish JC, Gilbert RW. Orbital floor reconstruction: 3-Dimensional analysis shows comparable morphology of scapular and iliac crest bone grafts. J Oral Maxillofac Surg 2018;76:2011-8. https://doi.org/10.1016/j.joms.2018.03.034
  5. Ilankovan V, Jackson IT. Experience in the use of calvarial bone grafts in orbital reconstruction. Br J Oral Maxillofac Surg 1992;30:92-6. https://doi.org/10.1016/0266-4356(92)90077-v
  6. Zhang WB, Mao C, Liu XJ, Guo CB, Yu GY, Peng X. Outcomes of orbital floor reconstruction after extensive maxillectomy using the computer-assisted fabricated individual titanium mesh technique. J Oral Maxillofac Surg 2015;73:2065.e1-15. https://doi.org/10.1016/j.joms.2015.06.171
  7. Young SM, Sundar G, Lim TC, Lang SS, Thomas G, Amrith S. Use of bioresorbable implants for orbital fracture reconstruction. Br J Ophthalmol 2017;101:1080-5. https://doi.org/10.1136/bjophthalmol-2016-309330
  8. Al-Khdhairi OBH, Abdulrazaq SS. Is orbital floor reconstruction with titanium mesh safe? J Craniofac Surg 2017;28:e692-4. https://doi.org/10.1097/SCS.0000000000003864
  9. Zimmerer RM, Ellis E 3rd, Aniceto GS, Schramm A, Wagner ME, Grant MP, et al. A prospective multicenter study to compare the precision of posttraumatic internal orbital reconstruction with standard preformed and individualized orbital implants. J Craniomaxillofac Surg 2016;44:1485-97. https://doi.org/10.1016/j.jcms.2016.07.014
  10. Hwang WJ, Lee DH, Choi W, Hwang JH, Kim KS, Lee SY. Analysis of orbital volume measurements following reduction and internal fixation using absorbable mesh plates and screws for patients with orbital floor blowout fractures. J Craniofac Surg 2017;28:1664-9. https://doi.org/10.1097/SCS.0000000000003730
  11. Oh TS, Jeong WS, Chang TJ, Koh KS, Choi JW. Customized orbital wall reconstruction using three-dimensionally printed rapid prototype model in patients with orbital wall fracture. J Craniofac Surg 2016;27:2020-4. https://doi.org/10.1097/SCS.0000000000003195
  12. Purnell CA, Vaca EE, Ellis MF. Orbital fracture reconstruction using prebent, anatomic titanium plates: technical tips to avoid complications. J Craniofac Surg 2018;29:e515-7. https://doi.org/10.1097/SCS.0000000000004563
  13. Fan B, Chen H, Sun YJ, Wang BF, Che L, Liu SY, et al. Clinical effects of 3-D printing-assisted personalized reconstructive surgery for blowout orbital fractures. Graefes Arch Clin Exp Ophthalmol 2017;255:2051-7. https://doi.org/10.1007/s00417-017-3766-y

Cited by

  1. 3D Printing in Eye Care vol.10, pp.4, 2021, https://doi.org/10.1007/s40123-021-00379-6