title: Orbital Wall Reconstruction with Two-Piece Puzzle 3D Printed Implants: Technical Note.
abstract: The purpose of this article is to describe a technique for secondary reconstruction of traumatic orbital wall defects using titanium implants that act as three-dimensional (3D) puzzle pieces. We present three cases of large defect reconstruction using implants produced by Xilloc Medical B.V. (Maastricht, the Netherlands) with a 3D printer manufactured by LayerWise (3D Systems; Heverlee, Belgium), and designed using the biomedical engineering software programs ProPlan and 3-Matic (Materialise, Heverlee, Belgium). The smaller size of the implants allowed sequential implantation for the reconstruction of extensive two-wall defects via a limited transconjunctival incision. The precise fit of the implants with regard to the surrounding ledges and each other was confirmed by intraoperative 3D imaging (Mobile C-arm Systems B.V. Pulsera, Philips Medical Systems, Eindhoven, the Netherlands). The patients showed near-complete restoration of orbital volume and ocular motility. However, challenges remain, including traumatic fat atrophy and fibrosis.
authors.affiliation: European Face Centre, Universitair Ziekenhuis Brussel, VUB, Brussels, Belgium; Orthoface Clinic, Oost-Vlaanderen, Belgium.
authors.forename: Maurice Y
authors.initials: MY
authors.lastname: Mommaerts
authors.affiliation: European Face Centre, Universitair Ziekenhuis Brussel, VUB, Brussels, Belgium.
authors.forename: Michael
authors.initials: M
authors.lastname: Büttner
authors.affiliation: European Face Centre, Universitair Ziekenhuis Brussel, VUB, Brussels, Belgium.
authors.forename: Herman
authors.initials: H
authors.lastname: Vercruysse
authors.affiliation: European Face Centre, Universitair Ziekenhuis Brussel, VUB, Brussels, Belgium.
authors.forename: Lauri
authors.initials: L
authors.lastname: Wauters
authors.affiliation: Xilloc Medical B.V, Maastricht, the Netherlands.
authors.forename: Maikel
authors.initials: M
authors.lastname: Beerens
keywords: computer-assisted; orbital fractures; printing; surgery; three-dimensional