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Rekonstruktive Orbitachirurgie


Wagner, M E H; Essig, H; Rücker, M; Gander, T (2018). Rekonstruktive Orbitachirurgie. HNO, 66(11):827-833.

Abstract

BACKGROUND:
In complex orbital reconstructions ideal positioning of the bony buttress and surrounding soft tissue is a prerequisite for an aesthetic and functional result. The use of computer-assisted surgery can support the surgeon before and during the reconstruction procedure and facilitate quality control processes. This is illustrated using three clinical examples.
MATERIAL AND METHODS:
The areas of interest (bony defect areas, surrounding tissues) are segmented in a 3D image series. In most cases, the contralateral non-affected side can serve as the reference in virtual reconstruction. The virtual model obtained can now be used for the manufacturing of patient specific models and implants, as well as for intraoperative navigation or direct quality control with the use of intraoperative cone beam computed tomography (CBCT).
RESULTS:
For the reconstruction of primary and secondary traumatic defects as well as for congenital malformations or neoplastic diseases, the presented workflow can be used. Preoperative virtual visualization, patient specific reconstruction and direct quality control using intraoperative CBCT ensure that the preoperatively planned result can be achieved. Together with the interplay of hard and soft tissue the best possible results can be achieved.
CONCLUSION:
Computer-assisted surgery has been continuously further developed over the last two decades and is currently used in the clinical routine. Patient specific implants in combination with the use of direct intraoperative quality control facilitate the reconstruction of complex orbital injuries and defects and enable the ideal reconstruction from both aesthetic and functional aspects.

Abstract

BACKGROUND:
In complex orbital reconstructions ideal positioning of the bony buttress and surrounding soft tissue is a prerequisite for an aesthetic and functional result. The use of computer-assisted surgery can support the surgeon before and during the reconstruction procedure and facilitate quality control processes. This is illustrated using three clinical examples.
MATERIAL AND METHODS:
The areas of interest (bony defect areas, surrounding tissues) are segmented in a 3D image series. In most cases, the contralateral non-affected side can serve as the reference in virtual reconstruction. The virtual model obtained can now be used for the manufacturing of patient specific models and implants, as well as for intraoperative navigation or direct quality control with the use of intraoperative cone beam computed tomography (CBCT).
RESULTS:
For the reconstruction of primary and secondary traumatic defects as well as for congenital malformations or neoplastic diseases, the presented workflow can be used. Preoperative virtual visualization, patient specific reconstruction and direct quality control using intraoperative CBCT ensure that the preoperatively planned result can be achieved. Together with the interplay of hard and soft tissue the best possible results can be achieved.
CONCLUSION:
Computer-assisted surgery has been continuously further developed over the last two decades and is currently used in the clinical routine. Patient specific implants in combination with the use of direct intraoperative quality control facilitate the reconstruction of complex orbital injuries and defects and enable the ideal reconstruction from both aesthetic and functional aspects.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic of Cranio-Maxillofacial Surgery
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Otorhinolaryngology
Uncontrolled Keywords:Otorhinolaryngology
Language:German
Date:1 November 2018
Deposited On:25 Jan 2019 15:08
Last Modified:29 Jul 2020 09:00
Publisher:Springer
ISSN:0017-6192
OA Status:Closed
Publisher DOI:https://doi.org/10.1007/s00106-018-0568-4
PubMed ID:30327822

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