[Enophthalmos correction in complex orbital floor reconstruction : computer-assisted, intraoperative, non-contact, optical 3D support].
In the case of displacement of the globe such as enophthalmos induced by trauma, the patient is affected on both counts: function and aesthetics. To prevent double vision or conspicuous asymmetry, exact correction of the globe position is required. The aim of this case report is to demonstrate an intraoperative computer-assisted, non-contact, optical 3D procedure for identification of the globe position to aid in placing the eyeball in the position required in complex reconstruction of the orbital floor. A 33-year-old man presented with a sunken eye on the right side in the horizontal and vertical plane 6 months after having undergone surgery elsewhere for a zygomatico-orbital fracture, also including the orbital floor. The patient was affected by double vision and a noticeable defective globe position. In planning the correction of the globe position, a three-dimensional image of the face with opened eyes was made with the optical sensor. Automatic comparison of symmetry revealed enophthalmos of 4 mm on relative en- and exophthalmometry. The decision was made to lift the orbital floor with a split calvarial bone graft. During surgery the position of the globe was also controlled by the three-dimensional optical technique. At the end of surgery there was exophthalmos of 1 mm. Six weeks after surgery the patient was not affected by any double vision. After 3 and 24 months enophthalmos was 1 mm. This case demonstrates how the non-ionizing, non-contact, optical 3D technique can help in planning, intraoperative transformation, and clinical monitoring to identify the correct position of the corneal vertex in complex orbital floor reconstruction.
Kühnel
T V
TV
Mund-, Kiefer- und Gesichtschirurgische Klinik, Universität Erlangen-Nürnberg, Glückstrasse 11, 91054, Erlangen, Deutschland. thomas.kuehnel@uk-erlangen.de
Vairaktaris
E
E
Schlegel
K A
KA
Neukam
F W
FW
Kühnel
B
B
Holbach
L M
LM
Nkenke
E
E
D000328:Adult; D003952:Diagnostic Imaging / Q000379:methods*; D003941:Diagnostic Techniques, Ophthalmological; D004172:Diplopia / Q000209:etiology / Q000601:surgery; D015841:Enophthalmos / Q000175:diagnosis / Q000601:surgery*; D005151:Facial Injuries / Q000150:complications / Q000601:surgery; D005593:Fracture Fixation, Internal; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D009915:Orbit / Q000293:injuries / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D012865:Skiing / Q000293:injuries; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014584:User-Computer Interface; D015051:Zygomatic Fractures / Q000150:complications / Q000601:surgery