Introduction: The anatomic reconstruction of extensive orbital injuries remains a challenge for the cranio-maxillofacial surgeon. New standardized 3D titanium mesh orbital implants (Synthes, USA) have been developed to facilitate orbital reconstruction. The results following orbital reconstruction using standardized 3D titanium mesh implants and the intraoperative control of the implant position by cone beam CT scan without computer assisted navigation are evaluated.

Material and method: Orbital reconstruction of extended orbital injuries using standard 3D orbital mesh implants (Synthes, USA) were performed in 27 patients with a mean age of 36,4 years during May 2008 and June 2010. Primary orbital reconstruction following trauma was performed in 16, secondary reconstruction in 8 patients and in three patients primarily following resection of orbital tumors. The location of the orbital implants was controlled using a C-Arm 3D cone beam CT intraoperatively (Philips, Germany). In complex cases the result of orbital reconstruction was analysed not only by the 3D comparison with the unaffected side but by image fusion of the intraoperative cone beam CT data and the preoperative virtual planning of the orbital reconstruction (IVS Solution, VoXim, Germany).

Result: A precise anatomical orbital reconstruction with a 3D accuracy of 1 mm was achieved in all 22 patients. An intraoperative correction of the position of the orbital implants to improve the implant position was performed in 4 out of 22 patients.

The orbital reconstruction was less time consuming and the reconstruction of orbital dimensions facilitated by using the 3D standardized orbital implants.