Aim: Post-traumatic enophthalmos or distopia may be a sequella of orbital fractures after inaccurate restoration of orbital anatomy. The preoperative computer-assisted planning with virtual correction has been combined with intraoperative navigation in an attempt to more accurately reconstruct the bony orbital walls. The purpose of this presentation is to show our experience with computer planning, and intraoperative navigation in patients with orbital wall fractures.
Material and methods: Eight patients with orbital trauma were included in this study. The imaging and planning platform used in this study was iPlan (Brainlab). Virtual correction was made using the uninjured side by creating a mirror image that was superimposed on the traumatized side and using the image of a contoured titanium orbital mesh (in floor of the orbit and medial wall) or a virtual guide for the reconstruction of the roof. Intraoperative navigation was used to assess the accuracy of walls restoration and the computer planning models were used intraoperatively as a virtual template to navigate the preplanned bony contours. All patients were reconstructed with a previously contoured titanium orbital mesh, either commercially available or molded in a skull.
Results: Enophthalmos decreased to less than 2 mm in all the patients. Anatomic restoration of orbital contours was obtained in all the patients according to the comparison of preoperative and postoperative CT scans. Accuracy was proved by comparing postoperative CT and the computed virtually planned reconstruction.
Conclusions: Preoperative computer modelling and intraoperative navigation is a useful guide and provides an accurate reconstruction of orbital fractures.
Key words: navigation; computer planning; orbital trauma