Classical versus custom orbital wall reconstruction: Selected factors regarding surgery and hospitalization

Publication date: Available online 17 February 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Rafał Zieliński, Marta Malińska, Marcin Kozakiewicz
PurposeNowadays, in orbital wall reconstruction, maxillofacial surgeons have the possibility to treat patients in modern ways such as with individual implants. Nevertheless, conventional treatment including standard titanium mesh shaped during the surgical procedure is also widely used. The aim of this study was to compare the above methods of orbital wall reconstructions.Materials and MethodsIn the first group (39 cases), patients were treated by means of computer-aided design/computer-aided manufacturing (CAD/CAM) milled individual implants made of ultra−high-molecular-weight polyethylene, dioxide zirconium and rapid prototyping titanium mesh pre-bent on an ABS model made by a three-dimensional (3D) printer. In the second group (54 cases), intraoperative bending of titanium mesh was implemented.ResultsOphthalmologic outcomes were the same in both groups. In patients who had greater destruction of the orbit, surgical procedures were longer regardless of the material used for individual implants (p<0.05). Time of surgery was shorter in patients in whom individual implants were used. Intraoperative bleeding was higher in patients who were treated using intraoperative bending titanium mesh (p<0.01).ConclusionApplication of CAD/CAM techniques do not give better ophthalmologic results in reference center but improve patient condition post-operatively. For this reason, CAD/CAM is a safer treatment method for patients.



http://ift.tt/2kZQWNf