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20 May 2010

Patient specific implants, designed using Rapid Prototyping and diagnostic imaging, for the repair of orbital fractures

Marcin T. Elgalal, Marcin Kozakiewicz, Piotr Loba, Bogdan Walkowiak, Marek Olszycki, Ludomir Stefańczyk

Med Sci Monit 2010; 16(1): 75-79 :: ID: 880587

Abstract

Background: Craniofacial trauma affects orbital structures in approximately 40% of all cases. Over the years, there has been a marked increase in applying preformed implants for the reconstruction of orbital fractures. Such implants significantly shorten operating times and decrease trauma to intraorbital structures during surgery. This study sought to create anatomic models of the bony orbit based on MSCT images, and use them as templates to form titanium mesh into custom, patient-specific implants for the reconstruction of orbital wall defects. Furthermore, the aim was to compare this new technique with a conventional method of treatment.
Material/Methods: A total of 30 patients with facial trauma and orbital fractures were included and divided into 2 groups. The first group of 15 subjects was treated with custom implants formed before surgery. The second group of 15 patients had been previously treated using a conventional method of manual implant formation during surgery. Both groups underwent ophthalmic evaluation and were statistically compared.
Results: Significant improvement in all cases was seen after surgery based on ophthalmic examination. There is a statistically significant superiority of RP (rapid prototyping) treatment method over CM (conventional method) when the area of diplopic vision (binocular single vision loss) and upgaze VVD (vertical visual disparity) reduction are considered.
Conclusions: With this new method of treatment, it is possible to use MSCT imaging to create accurate, individual implants. Such implants allow for precise reconstruction of tissue defects and better outcome.

Keywords: computerized tomography, rapid prototyping, computer models, Orbital Fractures, Orbital Implants

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750