Limits...
Virtual Surgical Planning for Orbital Reconstruction.

Susarla SM, Duncan K, Mahoney NR, Merbs SL, Grant MP - Middle East Afr J Ophthalmol (2015 Oct-Dec)

Bottom Line: The advent of computer-assisted technology has revolutionized planning for complex craniofacial operations, including orbital reconstruction.Orbital reconstruction is ideally suited for virtual planning, as it allows the surgeon to assess the bony anatomy and critical neurovascular structures within the orbit, and plan osteotomies, fracture reductions, and orbital implant placement with efficiency and predictability.The surgeon managing orbital pathology and posttraumatic orbital deformities can benefit immensely from utilizing virtual planning for various types of orbital pathology.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.

ABSTRACT
The advent of computer-assisted technology has revolutionized planning for complex craniofacial operations, including orbital reconstruction. Orbital reconstruction is ideally suited for virtual planning, as it allows the surgeon to assess the bony anatomy and critical neurovascular structures within the orbit, and plan osteotomies, fracture reductions, and orbital implant placement with efficiency and predictability. In this article, we review the use of virtual surgical planning for orbital decompression, posttraumatic midface reconstruction, reconstruction of a two-wall orbital defect, and reconstruction of a large orbital floor defect with a custom implant. The surgeon managing orbital pathology and posttraumatic orbital deformities can benefit immensely from utilizing virtual planning for various types of orbital pathology.

Show MeSH

Related in: MedlinePlus

Preoperative (top panels) and postoperative (bottom panels) frontal and submentovertex views of a male patient with thyroid orbitopathy who underwent computer-assisted orbital decompression
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4660529&req=5

Figure 1: Preoperative (top panels) and postoperative (bottom panels) frontal and submentovertex views of a male patient with thyroid orbitopathy who underwent computer-assisted orbital decompression

Mentions: Orbital decompression has been a mainstay of TED treatment since the 1950s. The variability in outcomes particularly in terms of proptosis and ocular alignment has resulted in the development of numerous surgical techniques for decompression with no clear consensus on which is most effective.4 The recent development of computer-assisted surgical planning and execution has the potential to result in more efficacious, consistent and predictable decompressions. Multiplanar CT scans with three-dimensional (3D) reconstruction allow the surgeon to carefully evaluate the individual anatomy and identify specific bone segments for resection. Intraoperatively, the CT images and the patient's anatomy are virtually overlapped allowing for stereotactic navigation throughout the case.5 This allows the surgeon to check his/her distance from important anatomical landmarks and to measure the extent of bony resection in order to carefully match preoperative planning.6 Postoperative imaging and assessment may be used to objectively quantify the magnitude of decompression and correlate this with clinical outcomes. The objective data provided by computer-assisted orbital decompression has the potential to result in safer, more efficacious and consistent decompressions. In the clinical example shown [Figures 1 and 2], real-time image guidance was utilized to allow for extensive, asymmetric decompression of the bilateral orbits (left: Lateral orbital wall, right: Medial and lateral walls).


Virtual Surgical Planning for Orbital Reconstruction.

Susarla SM, Duncan K, Mahoney NR, Merbs SL, Grant MP - Middle East Afr J Ophthalmol (2015 Oct-Dec)

Preoperative (top panels) and postoperative (bottom panels) frontal and submentovertex views of a male patient with thyroid orbitopathy who underwent computer-assisted orbital decompression
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660529&req=5

Figure 1: Preoperative (top panels) and postoperative (bottom panels) frontal and submentovertex views of a male patient with thyroid orbitopathy who underwent computer-assisted orbital decompression
Mentions: Orbital decompression has been a mainstay of TED treatment since the 1950s. The variability in outcomes particularly in terms of proptosis and ocular alignment has resulted in the development of numerous surgical techniques for decompression with no clear consensus on which is most effective.4 The recent development of computer-assisted surgical planning and execution has the potential to result in more efficacious, consistent and predictable decompressions. Multiplanar CT scans with three-dimensional (3D) reconstruction allow the surgeon to carefully evaluate the individual anatomy and identify specific bone segments for resection. Intraoperatively, the CT images and the patient's anatomy are virtually overlapped allowing for stereotactic navigation throughout the case.5 This allows the surgeon to check his/her distance from important anatomical landmarks and to measure the extent of bony resection in order to carefully match preoperative planning.6 Postoperative imaging and assessment may be used to objectively quantify the magnitude of decompression and correlate this with clinical outcomes. The objective data provided by computer-assisted orbital decompression has the potential to result in safer, more efficacious and consistent decompressions. In the clinical example shown [Figures 1 and 2], real-time image guidance was utilized to allow for extensive, asymmetric decompression of the bilateral orbits (left: Lateral orbital wall, right: Medial and lateral walls).

Bottom Line: The advent of computer-assisted technology has revolutionized planning for complex craniofacial operations, including orbital reconstruction.Orbital reconstruction is ideally suited for virtual planning, as it allows the surgeon to assess the bony anatomy and critical neurovascular structures within the orbit, and plan osteotomies, fracture reductions, and orbital implant placement with efficiency and predictability.The surgeon managing orbital pathology and posttraumatic orbital deformities can benefit immensely from utilizing virtual planning for various types of orbital pathology.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.

ABSTRACT
The advent of computer-assisted technology has revolutionized planning for complex craniofacial operations, including orbital reconstruction. Orbital reconstruction is ideally suited for virtual planning, as it allows the surgeon to assess the bony anatomy and critical neurovascular structures within the orbit, and plan osteotomies, fracture reductions, and orbital implant placement with efficiency and predictability. In this article, we review the use of virtual surgical planning for orbital decompression, posttraumatic midface reconstruction, reconstruction of a two-wall orbital defect, and reconstruction of a large orbital floor defect with a custom implant. The surgeon managing orbital pathology and posttraumatic orbital deformities can benefit immensely from utilizing virtual planning for various types of orbital pathology.

Show MeSH
Related in: MedlinePlus