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Precision of posttraumatic primary orbital reconstruction using individually bent titanium mesh with and without navigation: a retrospective study.

Essig H, Dressel L, Rana M, Rana M, Kokemueller H, Ruecker M, Gellrich NC - Head Face Med (2013)

Bottom Line: Orbital volume of the unaffected side ranged from 26.6 ml±2.8 ml in male and 25.2 ml±2.6 ml in female (CT).Significant orbital enlargement was found in orbital fractures with involvement of the posterior third of the orbital floor and in comminuted fracture pattern.Reconstructed orbital volume ranged from 26.9±2.7 ml in male and 24.26±2.5 ml in female (CBCT). 3D Analysis of the color mapping showed minor deviations compared to the mirrored unaffected side.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: The aim of orbital wall reconstruction is to reestablish anatomically exact orbital volumes to avoid long-term complications. Navigation could facilitate complex reconstructions.

Methods: Quality of the orbital reconstruction (n=94) was measured based on (A) volume changes and (B) on 3D shape deviations compared to the unaffected side. Volume analysis included segmentation of the orbital cavity in the pre- and post-operative 3D data set (VoXim®, IVS Solutions, Germany), and shape analysis was performed by vector-based 3D tools (Comparison®, 3Dshape, Germany).

Results: Orbital volume of the unaffected side ranged from 26.6 ml±2.8 ml in male and 25.2 ml±2.6 ml in female (CT). Significant orbital enlargement was found in orbital fractures with involvement of the posterior third of the orbital floor and in comminuted fracture pattern. Reconstructed orbital volume ranged from 26.9±2.7 ml in male and 24.26±2.5 ml in female (CBCT). 3D Analysis of the color mapping showed minor deviations compared to the mirrored unaffected side.

Conclusion: Measurements demonstrate that even in comminuted orbital fractures true-to-original reconstruction is feasible.

No MeSH data available.


Related in: MedlinePlus

3D shape analysis. (A) Manually superimposed pre- and post-operative virtual models – before matching procedure. (B) after matching procedure. (C) typical segmentation of a titanium mesh implant. (D) medial orbital wall as area of interest (green signifies no differences compared to the virtual planning). (E) orbital floor with transition zone to the medial wall (in red; differences are up to 1.5 mm). (F) complete titanium mesh implant shows an excellent result.
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Figure 3: 3D shape analysis. (A) Manually superimposed pre- and post-operative virtual models – before matching procedure. (B) after matching procedure. (C) typical segmentation of a titanium mesh implant. (D) medial orbital wall as area of interest (green signifies no differences compared to the virtual planning). (E) orbital floor with transition zone to the medial wall (in red; differences are up to 1.5 mm). (F) complete titanium mesh implant shows an excellent result.

Mentions: Three-dimensional analysis presupposed two proper aligned virtual stereolithographic models (STL-data) of firstly the template (mirrored unaffected side) and secondly the post-operative result (reconstructed side). The template of the unaffected side was segmented with VoXim® (IVS Solutions, Germany) and mirrored to the affected side (group Navi; n = 60). This procedure is a well-established step of the Computer-assisted pre-operative planning (CAPP). The form of the template included the complete bony orbit with extent to the orbital roof. The reconstructed side was accordingly segmented and both files were saved in STL-format. The aligning was performed with Comparison® (3Dshape, Germany). The region of interest (ROI) for the superimposing was limited to the orbital roof and non-affected areas of the bony orbit. This restriction prevented the matching algorithm to include the reconstructed area. The output of Comparison® was a color-coded template (Figure 3). This template was split into the anatomical regions (medial orbital wall, orbital floor, lateral orbital wall) and respectively subdivided into anterior, central, and posterior third. The spectrum was evaluated with analySIS 1.0 (Soft Imaging Systems, Muenster, Germany) and volume and shape data analyzed with SPSS 18 (IBM, USA).


Precision of posttraumatic primary orbital reconstruction using individually bent titanium mesh with and without navigation: a retrospective study.

Essig H, Dressel L, Rana M, Rana M, Kokemueller H, Ruecker M, Gellrich NC - Head Face Med (2013)

3D shape analysis. (A) Manually superimposed pre- and post-operative virtual models – before matching procedure. (B) after matching procedure. (C) typical segmentation of a titanium mesh implant. (D) medial orbital wall as area of interest (green signifies no differences compared to the virtual planning). (E) orbital floor with transition zone to the medial wall (in red; differences are up to 1.5 mm). (F) complete titanium mesh implant shows an excellent result.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750456&req=5

Figure 3: 3D shape analysis. (A) Manually superimposed pre- and post-operative virtual models – before matching procedure. (B) after matching procedure. (C) typical segmentation of a titanium mesh implant. (D) medial orbital wall as area of interest (green signifies no differences compared to the virtual planning). (E) orbital floor with transition zone to the medial wall (in red; differences are up to 1.5 mm). (F) complete titanium mesh implant shows an excellent result.
Mentions: Three-dimensional analysis presupposed two proper aligned virtual stereolithographic models (STL-data) of firstly the template (mirrored unaffected side) and secondly the post-operative result (reconstructed side). The template of the unaffected side was segmented with VoXim® (IVS Solutions, Germany) and mirrored to the affected side (group Navi; n = 60). This procedure is a well-established step of the Computer-assisted pre-operative planning (CAPP). The form of the template included the complete bony orbit with extent to the orbital roof. The reconstructed side was accordingly segmented and both files were saved in STL-format. The aligning was performed with Comparison® (3Dshape, Germany). The region of interest (ROI) for the superimposing was limited to the orbital roof and non-affected areas of the bony orbit. This restriction prevented the matching algorithm to include the reconstructed area. The output of Comparison® was a color-coded template (Figure 3). This template was split into the anatomical regions (medial orbital wall, orbital floor, lateral orbital wall) and respectively subdivided into anterior, central, and posterior third. The spectrum was evaluated with analySIS 1.0 (Soft Imaging Systems, Muenster, Germany) and volume and shape data analyzed with SPSS 18 (IBM, USA).

Bottom Line: Orbital volume of the unaffected side ranged from 26.6 ml±2.8 ml in male and 25.2 ml±2.6 ml in female (CT).Significant orbital enlargement was found in orbital fractures with involvement of the posterior third of the orbital floor and in comminuted fracture pattern.Reconstructed orbital volume ranged from 26.9±2.7 ml in male and 24.26±2.5 ml in female (CBCT). 3D Analysis of the color mapping showed minor deviations compared to the mirrored unaffected side.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: The aim of orbital wall reconstruction is to reestablish anatomically exact orbital volumes to avoid long-term complications. Navigation could facilitate complex reconstructions.

Methods: Quality of the orbital reconstruction (n=94) was measured based on (A) volume changes and (B) on 3D shape deviations compared to the unaffected side. Volume analysis included segmentation of the orbital cavity in the pre- and post-operative 3D data set (VoXim®, IVS Solutions, Germany), and shape analysis was performed by vector-based 3D tools (Comparison®, 3Dshape, Germany).

Results: Orbital volume of the unaffected side ranged from 26.6 ml±2.8 ml in male and 25.2 ml±2.6 ml in female (CT). Significant orbital enlargement was found in orbital fractures with involvement of the posterior third of the orbital floor and in comminuted fracture pattern. Reconstructed orbital volume ranged from 26.9±2.7 ml in male and 24.26±2.5 ml in female (CBCT). 3D Analysis of the color mapping showed minor deviations compared to the mirrored unaffected side.

Conclusion: Measurements demonstrate that even in comminuted orbital fractures true-to-original reconstruction is feasible.

No MeSH data available.


Related in: MedlinePlus