ABSTRACT The main aim of orbital fracture reconstruction is to restore the functional and aesthetic components of the eye. However, it is known that surgery for complex three-dimensional anatomy of the orbit is always a challenge. With recent advancements in technology, surgical predictability and outcomes have greatly improved. Several methods for orbital reconstruction surgery have been documented such as virtual surgical planning, intraoperative navigation, intraoperative imaging, and the use of patient-specific implant (PSI). PSI made of titanium can be designed by using a computer-aided design process and manufacturing (CAD-CAM) of CT-scan routinely used during diagnostic imaging. With precise analyses in shape and size followed by personalised implant design, the surgical precision can be alleviated further and at the same time, the surgical duration could be reduced with anticipation of better surgical outcomes. However, meticulous planning needs to be done preoperatively, with the timing of the surgery being an important factor. In the present case, pure orbital blowout fracture primarily treated with a personalised-implant solution derived from 3D-printing technology is described. Both pre-surgical and surgical workflow of this computer-assisted surgical method is elaborated. PSI for primary orbital reconstruction can be regarded as a viable alternative surgical solution including its working timeframe and adherence to the surgical protocol or algorithm.
Orbital Fractures--surgery ; Orbital Implants

Enophthalmos ; surgery ; Humans ; Orbital Fractures ; diagnosis ; surgery

Ethmoid Bone ; injuries ; Humans ; Orbital Fractures ; surgery ; Skull Fractures ; surgery

Adult ; Eye Injuries ; surgery ; Female ; Humans ; Orbital Fractures ; surgery

Diplopia ; etiology ; Fracture Fixation ; adverse effects ; methods ; Humans ; Orbital Fractures ; diagnosis ; diagnostic imaging ; surgery ; Orbital Implants ; Tomography, X-Ray Computed

OBJECTIVETo study the clinical characteristics and the treatment of periorbital injuries.

METHODS61 cases were treated, including 30 cases orbitozygomatic fracture, 6 cases of frontal-orbital fracture, 8 cases of naso-ethmoid-orbital fracture, 7 cases of blow -out fracture and 10 cases of complicated fracture. The patients were diagnosed after physical examination and other examination, like CT. Through bicoronal or local mini incision at the end of eyebrow, combined with subciliary incision and local wound approach, the fractured sites were exposed completely. Then the fractured fragments were repositioned and fixed rigidly. The orbital wall was reconstructed with titanium net and Medpor.

RESULTSThe wounds healed primarily. Good cosmetic and functional results achieved in most of the patients. 4 cases underwent second-stage ophthalmectomy. 2 patients had diplopia after operation, but improved gradually. 3 cases of blepharoptosis needed further treatment.

CONCLUSIONSEarly diagnosis and treatment is very important for periorbital injuries. Fracture reposition and orbital wall reconstruction should he performed at early period.

Adolescent ; Adult ; Aged ; Child ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Orbital Fractures ; surgery ; Skull Fractures ; surgery ; Young Adult

Ethmoid Bone ; injuries ; Facial Bones ; injuries ; Humans ; Nasal Bone ; injuries ; Orbital Fractures ; surgery ; Osteogenesis, Distraction ; Skull Fractures ; surgery

OBJECTIVEIn order to improve the diagnosis and treatment of the complex fracture of the orbit region and adjacent cranio-maxillofacial fracture.

METHODS73 cases with blowout fracture of the orbit and adjacent cranio-maxillofacial fracture in recent years were retrospectively analyzed and comparied with different methods of treatment. All cases had undertaken CT examinations.

RESULTSThe positive rate of the CT examinations with blowout fracture of the orbit and adjacent cranio-maxillofacial region were 100%. Operating repositioning, rigid fixation and artificial material placement were used to treat this kind of deformities.

CONCLUSIONSWith the progress of modern photographic methods, blowout fracture of the orbit and adjacent cranio-maxillofacial fracture can be diagnosed clearly and help the operation procedure. Operations with reduction, rigid fixation and filling materials can be used to restore this kind of fracture and appearance.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Male ; Maxillary Fractures ; surgery ; Maxillofacial Injuries ; surgery ; Middle Aged ; Orbital Fractures ; surgery ; Reconstructive Surgical Procedures ; Skull Fractures ; surgery

OBJECTIVE: To discuss the clinical features and treatment methods for simple orbital blowout fracture. METHOD: Retrospective analysis of the CT images of 16 orbital blowout fracture case, and identification of the sites, degree, patterns and features of fractures. Among the 16 cases, 2 cases adopted conservative treatment; 11 cases gained a reduction of orbital fracture through endoscopic transnasal surgery; the other 3 patients choosed endoscopic transnasal surgery and Caldwell-Luc operations. RESULT: Among 16 diplopia cases, 13 cases were completely cured, and 3 patients' vision were significantly improved. Among 11 enophthalmos cases, 10 patients were cured, and the effect of the other one was not satisfied. Among the 15 eye movement disorder cases, 13 patients' eye movement gained a full recovery, and the other 2 cases were nearly normal. All patients' vision were improved in different extents, and no one got a complication. CONCLUSION Computerized Tomography is helpful to the diagnosis of simple orbital blowout fracture. Caldwell-Luc operation with transnasal endoscope is an effective method for the treatment of orbital fractures.
Diplopia ; etiology ; Endoscopy ; Enophthalmos ; etiology ; Humans ; Orbital Fractures ; complications ; surgery ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVE: To investigate the surgical method of plerosising intra-orbital wall blow-out fracture through ethmoid sinuses under trans-nasal endoscopy with the graft of nasal septal cartilage. METHOD: Eighteen patients who encounter the intra-orbital wall blow-out fracture were plerosised under trans-nasal endoscopy through ethmoid sinuses. As a part of the surgical method, the nasal septal cartilage was taken as the graft. We analyzed the curative effect of the method. RESULT: The follow-up was from half a year to one year, all of the 18 patients met the cure standards without the graft prolapsus. CONCLUSION It is a feasible surgical method to plerosis intra-orbital wall blow-out fracture under the endoscopic transnasal with the graft of nasal septal cartilage through ethmoid sinuses, which is direct-viewing,micro- trauma, well-histocompatibility and so on.
Adolescent ; Adult ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Cartilages ; surgery ; Nasal Septum ; surgery ; Orbital Fractures ; surgery ; Young Adult