[CT-computer-template-assisted planning of implant and magnet position in epi-prosthetic management of facial defects].
BACKGROUND
The aesthetic result of a prosthetic reconstruction in the facial area depends on precise, long-term stable positioning of the facial prosthesis. For fixation of the facial prosthesis and contouring of the soft tissue, good long-term success can be achieved by implant-magnet systems. The precise positioning of the implants and magnets when only little bone is available is difficult and without any planning is often not possible.
Computer-supported evaluation of CT data with the aid of CT and drill templates can optimise the planning and carrying out of surgery. This procedure is illustrated with reference to the treatment of a patient following obital exenteration due to an embryonic rhabdomyosarcoma. The programs SIM/Plant and coDiagnostiX were compared with one another when carrying out the CT evaluation and planning the orbital prosthesis. In so doing, the great advantage of the definition of the CT window (grey levels), the freely definable panorama sections and cross-sections, as well as the three-dimensional, spatial representation using the programme coDiagnostiX on a conventional PC are made clear. The results of planning can be applied and implemented during surgery, with the aid of the CT and drill templates.


CONCLUSIONS
The CT computer template-supported procedure is suitable for routine clinical use and can be recommended for planning of implant-fixed facial prosthesis in the orbital area when little bone is available or in the case of difficult anatomical relationships.
Gemeinschaftspraxis Dr. Brinkmann und Dr. Dr. Schlieper, Hamburg.
J
J
Schlieper
B
B
Brinkmann
H J
HJ
Metz
D000293:Adolescent; D000328:Adult; D017076:Computer-Aided Design; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D017233:Orbit Evisceration / Q000534:rehabilitation*; D020273:Orbital Implants; D009918:Orbital Neoplasms / Q000601:surgery; D010347:Patient Care Planning; D019047:Phantoms, Imaging; D018233:Rhabdomyosarcoma, Embryonal / Q000601:surgery; D012984:Software; D014057:Tomography, X-Ray Computed