title: Computer-aided reconstruction of traumatic fronto-orbital osseous defects: aesthetic considerations.
abstract: BACKGROUND
  In addition to functional goals, a satisfactory aesthetic outcome is important for reconstruction of fronto-orbital osseous defects. The purpose of this study is to report on a method for presurgical fabrication of custom implants using 3-dimensional (3-D) imaging data and computer-assisted manufacturing techniques.
  
  
  METHODS
  Preoperative 3-D computed tomography data were processed and displayed for evaluation of defects. Implants were created by a computer-aided design/computer-aided manufacturing (CAD/CAM) program. A rapid prototyping system was applied for production of the physical models. Rehearsal of surgery was performed using the implants and skull models. Negative castings were created and were used during the operations to prepare the surgical implant utilizing methyl methacrylate. Traumatic fronto-orbital defects in 4 patients were reconstructed using this method. The follow-up period ranged from 29 to 55 months.
  
  
  RESULTS
  Results showed that the custom implants perfectly fit the defects during the operation. Symmetry and normal fronto-orbital contours were achieved. There were no peri- or postoperative complications. All patients were satisfied with the results.
  
  
  CONCLUSIONS
  Computer-aided presurgical simulation and fabrication of implants is a reliable and effective method for the reconstruction of traumatic fronto-orbital defects, with reduced anesthesia time and improved aesthetic outcomes.
authors.affiliation: Craniofacial Center, Department of Plastic and Reconstruction Surgery, Chang Gung Memorial Hospital, Chang Gun University, Taoyuan, Taiwan, ROC. lunjoulo@cgmh.org.tw
authors.forename: Lun-Jou
authors.initials: LJ
authors.lastname: Lo
authors.forename: Yu-Ray
authors.initials: YR
authors.lastname: Chen
authors.forename: Ching-Shiow
authors.initials: CS
authors.lastname: Tseng
authors.forename: Ming-Yih
authors.initials: MY
authors.lastname: Lee
mesh_terms: D000328:Adult; D002648:Child; D004954:Esthetics; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D009915:Orbit / Q000601:surgery*; D012886:Skull / Q000000981:diagnostic imaging / Q000601:surgery*; D013514:Surgical Procedures, Operative; D014057:Tomography, X-Ray Computed